Billing and Insurance AR Specialist
OneOncology is positioning community oncologists to drive the future of cancer care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer. Our team is bringing together leaders to the market place to help drive OneOncologys mission and vision. Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of community oncologists and the patients they serve. Job Description: The Billing and Insurance AR Specialist role reviews monthly accounts receivables, follow up for resolution, insurance contact and claim re-files when necessary. Responsible for all aspects of insurance management of assigned payers including follow-up, research, and problem resolutions. The individual will need to have expertise in medical billing and collections, as well as a strong understanding of insurance reimbursement processes. This position will also review billing edits and correct claims. The successful candidate will work closely with patients, physicians, and insurance companies to ensure that accurate and timely payments are received, and outstanding balances are collected. The role will also be responsible for accurately billing clinical research studies, ensuring proper coding and submission of claims to sponsors or payers for services rendered to clinical trial participants, while adhering to all relevant regulations and compliance guidelines; they review medical records, study protocols, and contracts to determine appropriate charges and manage the billing process for research studies, often collaborating with clinical research teams to guarantee accurate and timely reimbursement. This will be a hybrid role in Grand Rapids, MI. 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. Required Qualifications: High school diploma or equivalent required Bachelors degree preferred Minimum of 3 years of experience in medical collections required, preferably in an Oncology healthcare setting Radiation Oncology/Proton experience a plus Expertise in insurance policies and regulations related to medical billing, including Medicare and Medicaid Essential Competencies: Attendance is an essential job function. Detailed knowledge of billing, HCPCS, CPT and ICD codes Previous commercial collections experience preferred 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. #LI-HD1 #INDOneOnc OneOncology is the national platform for independent community oncology practices working together to improve the lives of everyone living with cancer through a physician-led, data-driven and patient-centric model. OneOncology provides practices on the platform with capital, innovative technology and expertise enabling them to grow, provide multi-disciplinary services along the continuum of care, incorporate the latest scientific developments as they emerge in the market, and attract the best physicians and employees as the landscape of oncology rapidly changes. OneOncology is comprised of practices representing nearly 600 providers practicing at more than 175 sites of care across the United States. Apply Job!