Insurance Specialist I - Radiotherapy Clinics of Georgia

The US Oncology Network believes local cancer care is better care and in 2017 Vantage Oncology joined The US Oncology Network. The US Oncology Network empowers the delivery of advanced integrated cancer care through our network of independent physicians who share expertise and resources to provide quality, value-based care close to home. Our clinical and business support capabilities, expertise and industry-leading technologies keep local practices at the forefront of high quality, efficient care delivery while enabling practice success, quality of life and financial security for physicians.

We have an immediate opening for a Full time Insurance Specialist.

SCOPE:  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 

ESSENTIAL DUTIES AND RESPONSIBILITIES

• 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 HIPPA laws and guidelines with regard to patient records

• Performs other duties as requested or assigned 

MINIMUM QUALIFICATIONS:

• High School diploma or equivalent required

• Minimum two (2) years combined medical billing and payment experience required

• 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 • Customer Service o 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 regularly required to sit and use hands to manipulate a computer keyboard and mouse. The employee is occasionally required to stand, walk, and reach with hands and arms. The employee must occasionally lift and/or move up to 30 pounds. Requires vision and hearing corrected to normal ranges.

WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations maybe made to enable individuals with disabilities to perform the essential functions. Work is performed in an office environment. Involves frequent contact with staff. While performing the duties of this job, the employee is regularly exposed to direct contact with patients with potential for exposure to blood, toxic substances, ionizing radiation and other conditions common to a clinic environment.