Insurance Specialist II

We are seeking an Insurance Specialist to join our team at Texas Oncology in Austin, Texas. This full-time position supports the Oncology Department at our 8501 N. Mopac Suite 310 location. The typical work week is Monday through Friday, 8:30 AM – 5:00 PM.

As part of The US Oncology Network, Texas Oncology delivers high-quality, evidence-based care to patients close to home. We are the largest community oncology provider in the country, with approximately 530 providers across 280+ sites in Texas. Our mission is to use leading-edge technology and research to deliver high-quality, evidence-based cancer care, helping patients achieve “More breakthroughs. More victories.” in their fight against cancer. Today, Texas Oncology treats half of all Texans diagnosed with cancer annually.

Responsibilities

• Monitors delinquent accounts and performs collection duties.
• Reviews reports, researches, and resolves issues.
• Reviews payment postings for accuracy and ensures account balances are current.
• Works with co-workers to resolve insurance payment and billing errors.
• Monitors and updates delinquent accounts status.
• Recommends accounts for collection or write-off.
• 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.
• Maintains credit balances of patients and payors, ensuring timely refunds within government guidelines/regulations.
• Adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regard to patient records.
• Performs other duties as requested or assigned.

Requirements

• Level 1:
  • High School diploma or equivalent required.
  • Minimum two (2) years combined medical billing and payment experience required.
  • Demonstrate knowledge of state, federal, and third-party claims processing required.
  • Demonstrate knowledge of state & federal collections guidelines.
  • Must successfully complete required e-learning courses within 90 days of occupying position.
• Level 2 (in addition to Level 1 Requirements):
  • Minimum four (4) years combined medical billing and payment experience required.
  • Demonstrate knowledge of medical coding, preferably oncology coding.
• Level Sr (in addition to Level 1 and 2 Requirements):
  • Associates degree in Finance, Business, or four years revenue cycle experience preferred.
  • Minimum two (2) years insurance resolution experience resolving issues with patients and payers, as well as four (4) years combined medical billing and payment experience required.
  • Proficiency with computer systems and Microsoft Office (Word and Excel) required.
  • Demonstrate knowledge of oncology medical coding.
  • Demonstrate knowledge of state, federal, and third-party claims processing required.

Skills

• Uses Technical and Functional Experience:
  • Possesses up-to-date knowledge of the profession and industry.
  • Accesses and uses resources when appropriate.
• Demonstrates Adaptability:
  • Handles day-to-day work challenges confidently.
  • Willing and able to adjust to multiple demands, shifting priorities, ambiguity, and rapid change.
  • Shows resilience in the face of constraints, frustrations, or adversity.
  • Demonstrates flexibility.
• Customer Service:
  • Demonstrates positive interpersonal relations in dealing with fellow employees, supervisors, physicians, patients, as well as outside contacts to maximize productivity and positive employee/patient relations.
• Uses Sound Judgment:
  • Makes timely, cost-effective, and sound decisions.
  • Makes decisions under conditions of uncertainty.
• Shows Work Commitment:
  • Sets high standards of performance.
  • Pursues aggressive goals and works efficiently to achieve them.
• Commits to Quality:
  • Emphasizes the need to deliver quality products and/or services.
  • Defines standards for quality and evaluates products, processes, and services against those standards.
  • Manages quality and improves efficiencies.

Schedule

Monday through Friday, 8:30 AM – 5:00 PM.

Physical Demands

• Regularly required to sit and use hands to manipulate a computer keyboard and mouse.
• Occasionally required to stand, walk, and reach with hands and arms.
• Must occasionally lift and/or move up to 30 pounds.
• Requires vision and hearing corrected to normal ranges.

Work Environment

• Work is performed in an office environment with frequent contact with staff.
• Regular exposure to direct contact with patients, with potential for exposure to blood, toxic substances, ionizing radiation, and other conditions common to a clinic environment.