AR Medical Insurance Specialist Lead - Remote

The US Oncology Network; Norfolk (VA); Remote; USD 34,000 - 41,000; Full time

Benefits offered by this job

Health plans

Dental plans

Vision plans

Wellness program

Health savings account

Flexible spending accounts

401(k) retirement plan

Life insurance

Short-term disability

Long-term disability

Employee Assistance Program

Paid time off (PTO)

Holiday pay

Critical illness insurance

Accident insurance

Job summary

The US Oncology Network seeks a Remote Insurance Specialist Lead to oversee revenue cycle activities and ensure accurate claims processing.

You will monitor workloads, reassign tasks, train staff, and ensure timely collections while upholding HIPAA, compliance programs, and our shared values.

This role offers pay in the range of $25–30 per hour, with benefits including health, dental, vision, 401(k), and disability coverage as part of eligibility.

Qualifications

• High School diploma or equivalent; Associates degree preferred.
• Minimum two years insurance resolution experience; four years combined medical billing experience.
• Proficiency with computer systems and Microsoft Office (Word and Excel).
• Knowledge of oncology medical coding.
• Knowledge of medical billing, payor processes and procedures.
• Knowledge of state, federal, and third party claims processing.
• Knowledge of state and federal collections guidelines.
• Must complete required e-learning within 90 days.

Responsibilities

• Monitors revenue cycle workload with minimal supervision and reassigns tasks to meet deadlines.
• Performs all revenue cycle responsibilities as needed to meet deadlines.
• Uses broad knowledge of procedures, policies, regulations, and systems to accomplish goals.
• Directs workload and provides guidance to co-workers; trains staff on policies.
• Reviews reports to verify collection and billing submission tasks are completed on time.
• Codes, processes, and submits insurance claims to third-party payors.

Skills

Insurance resolution experience

Microsoft Office

Oncology medical coding

Billing and payment processes

State and federal claims processing

Education

High School diploma

Associates degree

Tools

Microsoft Office suite

Electronic medical records (EMR)

Job description

Overview

Come join our team in the fight against cancer!

The US Oncology Network is one of the nation’s largest networks of community-based oncology physicians dedicated to advancing cancer care in America. The US Oncology Network is supported by McKesson Corporation focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology and quality of care.

Remote Insurance Specialist Lead

US Oncology is a thriving organization that fosters forward-thinking, advancement opportunities, and an inspired work environment. We continuously look for top talent who will continue to propel our organization in the right direction and celebrate new successes! Come join our team in the fight against cancer!

Pay Range

Pay Range: $25-30/hr

Pay is based on several factors including but not limited to education, work experience, etc. As of the date of this posting, in addition to your salary, we offer the following benefits for this position, subject to eligibility requirements: Health, dental, and vision plans; wellness program; health savings account; flexible spending accounts; 401(k) retirement plan; life insurance, short-term disability insurance; long-term disability insurance, Employee Assistance Program; PTO, holiday pay, and employee paid critical illness and accident insurance.

Scope

• With little or no supervision, monitors the revenue cycle work load and reassigns work as necessary to meet deadlines
• Performs all revenue cycle job responsibilities as needed to meet deadlines
• Utilizes broad range of knowledge including operating procedures, policies, regulations, and systems to accomplish responsibilities
• A certain degree of creativity and latitude is required
• Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards, and US Oncology’s Shared Values

Responsibilities

Directs the revenue cycle work load of co-workers including auditing work for accuracy and completeness, re-assigning work, and establishing priorities.

• Reviews reports to verify that collection and billing submission tasks are completed and deadlines are met
• Provides procedure guidance and direction to co-workers
• May research, resolve, or provide direction on co-workers’ escalated issues
• Trains co-workers on policies and procedures
• Verifies existing patients have necessary referral and/or authorization documentation prior to examination date
• Contacts and follows up with patient’s physician for any missing or incomplete documentation
• Spot checks patient charts for completeness
• Contacts clinical staff for clarification on procedures or diagnosis and on missing information
• Reviews reports for claim denials and works with co-workers on status and problem resolution
• Reviews payment postings for accuracy and to ensure account balances are current
• Performs detailed account reconciliation to resolve issues
• Codes, processes, and submits insurance claims to third party payor
• Identifies and reports any payer trends, denial patterns, and delays to management and recommends write-offs
• Adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regard to patient records
• Maintains credit balances of patients and payors ensuring timely refunds within government guidelines/regulations
• Proactively identifies revenue cycle process and procedure gaps and develops tools to improve efficiencies
• Maintains and updates the Practice’s revenue cycle Standard Operating Procedures (SOPs)
• Trains coworkers on revenue cycle policies and procedures
• May develop training materials and tools
• Performs other duties as requested or assigned

Qualifications

Minimum Qualifications:

• High School diploma or equivalent required, Associates degree preferred.
• Minimum two (2) years insurance resolution experience resolving issues with patients and payors as well as four (4) years combined automated medical billing and payment experience required
• Proficiency with computer systems and Microsoft Office (Word and Excel) required
• Demonstrate knowledge of oncology medical coding required
• Demonstrate knowledge of medical billing, payment, financial aid, insurance, and payor processes and procedures
• Demonstrate knowledge of state, federal, and third party claims processing required
• Demonstrate knowledge of state and federal collections guidelines required
• Must successfully complete required e-learning courses within 90 days of occupying position

Competencies

• Uses Technical and Functional Experience
• Possesses up to date knowledge of the profession and industry
• Is regarded as an expert in the technical/functional area
• Accesses and uses other expert resources when appropriate
• Demonstrates Adaptability
• Handles day to day work challenges confidently
• Is 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
• 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
• Improves efficiencies

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present online during regularly scheduled business hours and regularly required to sit or stand and talk or hear. The position requires full range of body motion manual and finger dexterity, and eye-hand coordination. The position requires sitting for extensive periods of time. The employee occasionally lifts and carries items weighing up to 40 lbs. The position requires corrected vision and hearing to normal range.

Work Environment

Work will involve online interaction with co-workers and management and/or clients. Work may require minimal travel.