Insurance Specialist II

Responsibilities

• Maintains delinquent accounts and performs collection duties.
• Reviews reports, researches, and resolves issues related to billing and payments.
• Ensures accuracy of payment postings and maintains current account balances.
• Updates delinquent accounts status and recommends accounts for collection or write-off.
• Contacts patients to secure past due balances, verifies patient demographics, and updates information in systems.
• Documents conversations and answers patient payment, billing, and insurance questions.
• May refer patients to a Patient Benefits Representative to set up payment plans.
• Maintains credit balances of patients and payors, ensuring timely refunds within government guidelines.
• Adheres to confidentiality, state, federal, and HIPAA laws and guidelines regarding patient records.
• Performs other duties as requested or assigned.

Qualifications

• 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.
• Demonstrate knowledge of state & federal collections guidelines.
• Must successfully complete required e-learning courses within 90 days of occupying position.

Physical Demands

• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination.
• Requires standing and walking for extended periods of time.
• Occasionally lifts and carries items weighing up to 40 lbs.
• Requires corrected vision and hearing to normal range.

Work Environment

• The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations, and other conditions common to an oncology/hematology clinic environment.
• Work involves in-person interaction with co-workers and management and/or clients.
• Minimal travel by automobile to office sites may be required.