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Insurance Specialist - CBO Tucson
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Insurance Specialist - CBO Tucson

Job Description

 

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 FUNCTIONS:

 

• Monitors delinquent accounts and performs collection duties

 

• Reviews reports, identifies denied claims, researches and resolves issues, may perform a detailed reconciliation of accounts, and resubmits claim to payer

 

• Reviews payment postings for accuracy and to ensure account balances are current

 

• Works with co-workers to resolve payment and billing errors

 

• Monitors and updates delinquent accounts status

 

• Recommends accounts for collection or write-off

 

• Verifies existing patients have necessary referral and/or authorization documentation prior to examination date

 

• Contacts and follows up with patient’s physician for any missing or incomplete documentation

 

• 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

 

• Contacts third party payors to resolve payor issues, expedite claim processing, and maximize medical claim reimbursement

 

• 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.

   

 

Job Requirements

 

 

MINIMUM QUALIFICATIONS:

 

• 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

 

Job Snapshot

Employment Type Full-Time
Job Type Health Care
Education Not Specified
Experience At least 4 year(s)
Manages Others Not Specified
Industry Healthcare - Health Services
Required Travel Negligible
Job ID Insurance Specialist
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Insurance Specialist - CBO Tucson


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