Insurance Specialist

Under general supervision, is responsible for payer and patient account balances being paid timely and remaining current * Performs collection activities such as monitoring delinquent accounts, contacting patients for account payment, resolving billing problems, and answering routine and non-routine account inquiries * Follows standard procedures and pre-established guidelines to complete tasks * Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards, and US Oncology's Shared Values

* Monitors delinquent accounts and performs collection duties
* Reviews reports, researches and resolves issues
* Reviews payment postings for accuracy and to ensure account balances are current
* Works with co-workers to resolve insurance payment and billing errors
* Monitors and updates delinquent accounts status
* Recommends accounts for collection or write-off
* Contacts patients to secure past due balances, verifies patient demographics and insurance providers, updates information in systems, and documents conversations.
* Answers patient payment, billing, and insurance questions and resolves complaints.
* Contacts patients to secure past due balances, verifies patient demographics and insurance providers, updates information in systems, and documents conversations
* Answers patient payment, billing, and insurance questions and resolves complaints
* May refer patients to Patient Benefits Representative to set up payment plans
* Maintains credit balances of patients and payors ensuring timely refunds within government guidelines/regulations
* Adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regard to patient records
* Performs other duties as requested or assigned

* High School diploma or equivalent required * Minimum four (4) years combined medical billing and payment experience required * Demonstrate knowledge of medical coding, preferably oncology coding * Demonstrate knowledge of state, federal, and third party claims processing required * Demonstrate knowledge of state & federal collections guidelines * Must successfully complete required e-learning courses within 90 days of occupying position

COMPETENCIES * Uses Technical and Functional Experience * Possesses up to date knowledge of the profession and industry * Accesses and uses resources when appropriate * Demonstrates Adaptability * Handles day to day work challenges confidently * Is willing and able to adjust to multiple demands, shifting priorities, ambiguity, and rapid change * Shows resilience in the face of constraints, frustrations, or adversity * Demonstrates flexibility * Demonstrates positive interpersonal relations in dealing with fellow employees, supervisors, physicians, patients as well as outside contacts so that productivity and positive employee/patient relations are maximized. * Uses Sound Judgment * Makes timely, cost effective, and sound decisions * Makes decisions under conditions of uncertainty * Shows Work Commitment * Sets high standards of performance * Pursues aggressive goals and works efficiently to achieve them * Commits to Quality * Emphasizes the need to deliver quality products and/or services * Defines standards for quality and evaluates products, processes, and services against those standards * Manages quality * Improves efficiencies

PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. The position requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. The position requires standing and walking for extensive periods of time. The employee occasionally lifts and carries items weighing up to 40 lbs. The position requires corrected vision and hearing to normal range.

WORK ENVIRONMENT The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites.