Billing & Insurance AR Specialist

Summary

OneOncology is a patient-centric, physician-driven, and technology-powered oncology organization focused on improving care for people living with cancer and other diseases. The Billing & Insurance AR Specialist manages accounts receivable, insurance follow-up, claim corrections and re-files, billing edits, and collections while coordinating with patients, physicians, and insurance companies to ensure timely payments.

Responsibilities

• Works and/or maintains every account in the assigned AR in the 45+ day categories. Reviews EOBs within a two-week turnaround
• Documents accurate collection activity in the collection tracking notes
• Evaluates status of accounts and prioritizes collection action (letters, phone calls, staff assistance)
• Calls on outstanding balances due from carriers in a timely manner
• Telephone, interview, and counsel patients on outstanding self-pay balances
• Responds to incoming telephone or mail inquiries in a prompt, timely manner
• Completes write-off adjustment forms for accounts that need review
• Review claim edit failures and correct billing for clean claim submissions
• Advises Supervisor of any unusual collection accounts as they become delinquent or are in question
• Prepares daily user reports for Supervisor review and filing along with appropriate notes/documentation
• Work with other members of the RCM team to ensure clean claims and timely payment
• Maintains a complete understanding of HCPCS/ICD/CPT oncology coding and specific carrier requirements/knowledge
• Additional responsibilities may be assigned to help drive our mission of improving the lives of everyone living with cancer

Skills

• High school diploma or equivalent required
• Minimum of 3 years of experience in medical collections required, preferably in an Oncology healthcare setting
• Expertise in insurance policies and regulations related to medical billing, including Medicare and Medicaid
• Attendance is an essential job function
• Detailed knowledge of billing, HCPCS, CPT and ICD codes
• Ability to work effectively with all levels of management and other colleagues, demonstrating initiative, mature judgment and customer service orientation
• Effective verbal and written communications, including active listening skills and skill in presenting findings and recommendations
• Exceptional Multi-tasking, organizational skills and superb attention to detail
• Strong analytical skills
• Skill in negotiating issues and resolving problems
• Excellent customer service skills
• Proficient in the use of end-user computer applications regarding productivity (MS Word, Excel, Outlook), database and patient billing and other medical information systems
• Ability to operate various types of office equipment
• Must possess high degree of professionalism and adaptability
• Bachelor's degree preferred
• Radiation Oncology/Proton experience a plus
• Previous commercial collections experience preferred

Qualifications

Must Haves

• High school diploma or equivalent required
• Minimum of 3 years of experience in medical collections required, preferably in an Oncology healthcare setting
• Expertise in insurance policies and regulations related to medical billing, including Medicare and Medicaid
• Attendance is an essential job function
• Detailed knowledge of billing, HCPCS, CPT and ICD codes
• Ability to work effectively with all levels of management and other colleagues, demonstrating initiative, mature judgment and customer service orientation
• Effective verbal and written communications, including active listening skills and skill in presenting findings and recommendations
• Exceptional Multi-tasking, organizational skills and superb attention to detail
• Strong analytical skills
• Skill in negotiating issues and resolving problems
• Excellent customer service skills
• Proficient in the use of end-user computer applications regarding productivity (MS Word, Excel, Outlook), database and patient billing and other medical information systems
• Ability to operate various types of office equipment
• Must possess high degree of professionalism and adaptability

Nice to Haves

• Bachelor's degree preferred
• Radiation Oncology/Proton experience a plus
• Previous commercial collections experience preferred

Benefits

• Remote work arrangement