OneOncology

Operates network of community oncology practices

Insurance AR Specialist

Accounts Payable/ReceivableConfirmed live in the last 24 hours

Full-timeRemote in USANo salary listedRemote

About the Job

Requirements

A high school diploma or equivalent is required.
A bachelor's degree is preferred.
At least 3 years of medical collections experience is required; experience in an oncology healthcare setting is preferred.
Expertise in insurance policies and regulations related to medical billing, including Medicare and Medicaid, is required.
Detailed knowledge of billing, HCPCS, CPT, and ICD codes is required.
Ability to use end-user productivity applications such as Microsoft Word, Excel, and Outlook, databases, patient billing systems, and other medical information systems is required.
Ability to operate various types of office equipment is required.
Effective verbal and written communication, active listening, and the ability to present findings and recommendations are required.
Strong analytical skills, negotiation skills, problem-solving ability, customer service skills, and attention to detail are required.
Ability to work effectively with all levels of management and colleagues, demonstrating initiative, mature judgment, professionalism, adaptability, multitasking, and organizational skills, is required.
Attendance is an essential job function.

Responsibilities

Review monthly accounts receivable, follow up for resolution, contact insurance companies, and re-file claims when necessary.
Manage assigned payers, including follow-up, research, and problem resolution.
Work or maintain every account in assigned accounts receivable that is in the 60+ day categories, and review explanations of benefits within a two-week turnaround.
Document collection activity accurately in collection tracking notes.
Evaluate account status and prioritize collection actions, including letters, phone calls, and staff assistance.
Contact carriers about outstanding balances in a timely manner.
Telephone, interview, and counsel patients about outstanding self-pay balances.
Respond promptly to incoming telephone or mail inquiries.
Complete write-off adjustment forms for accounts requiring adjustments and submit them to the supervisor with appropriate documentation.
Maintain collection logs for distribution to other teams to help identify areas needing attention or correction.
Advise the supervisor of unusual collection accounts as they become delinquent or are in question.
Prepare daily user reports for supervisor review and filing, with appropriate notes and documentation.
Work with other departments to gather information needed for account work and collection activity.
Maintain a complete understanding of HCPCS and ICD/CPT oncology coding and specific carrier requirements and knowledge.
Work closely with patients, physicians, and insurance companies to help ensure accurate and timely payments and collection of outstanding balances.
Undertake additional responsibilities as assigned.

Desired Qualifications

Radiation oncology or proton experience is a plus.
Previous commercial collections experience is preferred.

OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases. 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, urology, 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 independent physicians and the patients they serve.

Job Description:

Role Summary:

This 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 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.

#LI-REMOTE

About the Company

OneOncology

Operates network of community oncology practices

OneOncology builds a network of community-based oncology practices and partners with them to deliver advanced cancer care across the United States. It works by investing in clinical, operational, and technical capabilities and providing a shared data analytics and technology platform, while local practice leadership remains in place. This approach differentiates OneOncology by preserving physician leadership and community focus, aided by a centralized, data-driven system that coordinates care and standardizes practices. The goal is to widen access to high-quality cancer treatment in communities nationwide and improve patient outcomes.

Company size: 501-1,000
Company stage: Acquired
Total funding: $685M
Headquarters: Nashville, TN
Founded: 2018

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