Insurance AR Specialist

Overview

This role involves managing insurance accounts receivable with a focus on oncology-related services including proton therapy, radiation therapy, and radiology. The Insurance AR Specialist is responsible for reviewing monthly accounts, following up on outstanding balances, contacting insurance carriers, and re-filing claims as necessary. The position requires expertise in medical billing and collections, strong knowledge of insurance reimbursement processes, and collaboration with patients, physicians, and insurance companies to ensure timely and accurate payments.

Responsibilities

• Manage accounts receivable in the 60+ day category, reviewing Explanation of Benefits (EOBs) within two weeks.
• Document collection activities accurately in tracking notes.
• Evaluate account status and prioritize collection actions such as letters, phone calls, and staff assistance.
• Contact insurance carriers promptly regarding outstanding balances.
• Communicate with patients regarding outstanding self-pay balances.
• Respond promptly to incoming telephone and mail inquiries.
• Complete write-off adjustment forms with appropriate documentation and submit to supervisor.
• Maintain collection logs for distribution to other teams to identify areas needing attention.
• Notify supervisor of unusual or delinquent collection accounts.
• Prepare daily user reports for supervisor review and filing.
• Collaborate with other departments to gather necessary information for account work and collection activities.
• Maintain comprehensive knowledge of HCPCS, ICD, CPT oncology coding, and specific carrier requirements.
• Perform additional duties as assigned to support the mission of improving cancer care.

Requirements

• High school diploma or equivalent required; Bachelor’s degree preferred.
• Minimum of 3 years of experience in medical collections, preferably in an oncology healthcare setting.
• Detailed knowledge of billing codes including HCPCS, CPT, and ICD.
• Experience with insurance policies and regulations related to medical billing, including Medicare and Medicaid.
• Previous commercial collections experience preferred.
• Strong verbal and written communication skills, including active listening and presentation abilities.
• Excellent multi-tasking, organizational skills, and attention to detail.
• Strong analytical and problem-solving skills.
• Proficient in Microsoft Word, Excel, Outlook, and medical billing/information systems.
• Ability to operate various office equipment.
• High degree of professionalism, adaptability, and customer service orientation.
• Ability to work effectively with all levels of management and colleagues.

Preferred Qualifications

• Experience in Radiation Oncology or Proton therapy billing is a plus.

Location

Details regarding the work location are not specified in this description.