AR Specialist

Astera Cancer Care; Goldsboro (NC); On-site; USD 42,000 - 68,000; Full time

Job summary

SMOC is seeking a Medical Billing Specialist to manage accounts receivable, insurance follow-up, and claim re-files for oncology patients in Goldsboro, NC. You will work with patients, physicians, and carriers to ensure accurate and timely payments and to reduce past-due balances.

The role requires solid knowledge of HCPCS/ICD/CPT oncology coding, Medicare/Medicaid familiarity, and strong attention to detail, communication, and multitasking. Prior cancer-care billing experience is a plus.

Qualifications

• Minimum of 3 years of experience in medical collections.
• Experience in oncology healthcare setting preferred.
• Strong knowledge of insurance policies and regulations related to medical billing.

Responsibilities

• Reviews EOBs within a two-week turnaround.
• Documents accurate collection activity in the collection tracking notes.
• Evaluates status of accounts and prioritizes collection action.
• Calls on outstanding balances due from carriers in a timely manner.
• Counsels patients on outstanding self-pay balances by phone or in person.
• Responds to inquiries via phone or mail promptly.
• Prepares write-off adjustment forms with documentation and submits to supervisor.
• Maintains collection logs and shares with other teams as needed.
• Advises supervisor of unusual delinquent accounts.
• Prepares daily reports for supervisor review with notes.

Skills

Medical collections

Insurance policy knowledge

Communication skills

Analytical skills

Multitasking

Customer service

MS Word

MS Excel

MS Outlook

HCPCS/ICD/CPT oncology coding

Education

High school diploma or equivalent

Bachelor’s degree preferred

Tools

MS Word

MS Excel

MS Outlook

Job description

Why Join Us?SMOC is proud to have a team of professionals who share our passion for and commitment to excellence and our sense of compassion.Job Description: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 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 requiredBachelor’s degree preferredMinimum of 3 years of experience in medical collections required, preferably in an Oncology healthcare settingRadiation Oncology/Proton experience a plusExpertise in insurance policies and regulations related to medical billing, including Medicare and MedicaidEssential Competencies:Attendance is an essential job function.Detailed knowledge of billing, HCPCS, CPT and ICD codesPrevious commercial collections experience preferredAbility 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 skillsSkill 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.The above job description is a general overview of the responsibilities and competencies for this role at SMOC. Specific details may vary based on the needs of the organization.