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Insurance Specialist - CBO Tucson

Insurance Specialist - CBO Tucson

Job Description




• 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, 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





• 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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