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 OneOncology’s 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 Insurance AR Specialist 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 and regulations related to proton therapy, radiation therapy, and radiology services. 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.
Responsibilities:
Works and/or maintains every account in the assigned AR in the 60+ 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 needing necessary adjustments and turns in to supervisor with appropriate documentation attached.
Maintains collection logs for distribution to other teams for use in identifying areas needing attention/correction.
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.
Works with other departments to gather necessary information for proper account work/collection activity.
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
Bachelor’s 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.
Tennessee Oncology is one of the nation’s largest community-based cancer care specialists and home to one of the leading clinical trial networks in the country.
Established 1976 in Nashville, Tennessee Oncology’s mission remains unchanged: To provide access to high quality cancer care and the expertise of clinical research for all patients at convenient locations within their community and close to their home. To this day, our growing network of physicians and number of locations is based on this mission. In 2018, Tennessee Oncology joined OneOncology, a partnership of oncologists and industry leading experts driving the future of community-based cancer care in the United States, as a founding practice partner.
Physicians specializing in gynecologic oncology, palliative care, radiation oncology, and health psychology comprise our group.
Tennessee Oncology provides a full range of diagnostic services, including oncology specific expertise in PET/CT and laboratory services. Clinic locations provide on-site chemotherapy treatments so that patients receive care in their community and close to their home.
Our physicians utilize the latest in molecular diagnostics and profiling to choose treatments specific to the genetics of your cancer.
Oncology research is the largest area of new drug development. Self -administered medications, those taken by mouth or injected by the patient, comprise approximately 40% of these investigative medications. Tennessee Oncology’s in house pharmacy, Park Pharmacy, stocks oncology and hematology medications not readily available at community retail pharmacies. A URAC accredited Specialty Pharmacy, Park provides insurance and benefits investigation, prior authorization services for insurance coverage, co-pay assistance through manufacturer or foundation programs, extensive medication education, and access to a pharmacist 24 hours a day, 7 days a week.
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