Claims Corrections Specialist

Astera Cancer Care; Northern (KY); Hybrid; USD 50,000 - 70,000; Full time

Job summary

OneOncology is seeking a Claims Corrections Specialist to ensure accurate charges and payments by reviewing insurance changes, denials, and posting errors. You will work under the RCM Manager to correct and reprocess claims across payer guidelines, while maintaining thorough documentation and supporting efficient workflows.

The role requires a background in medical billing, strong data entry, and solid communication skills, with remote/integrated team collaboration.

Qualifications

• High School diploma or equivalent required.
• Two years cash posting and/or medical billing experience in a physician practice setting required.
• One year of experience in directly related role preferred.

Responsibilities

• Update charges in the Practice Management system due to insurance changes or payment errors.
• Reappoint charges for secondary or tertiary insurance changes.
• Resolve payer file rejections promptly.
• Interpret insurance payments, denials and reprocesses from explanations of benefits.
• Submit corrected claims per payer guidelines for denials.
• Collaborate with RCM Manager and teams to improve workflows.
• Maintain documentation and tracking of errors and insurance changes.

Skills

Medical billing

Billing codes (HCPCS CPT ICD)

Revenue Cycle Management

Data entry

MS Office (Word, Excel, Outlook)

Customer service

Communication skills

Attendance

Tools

Practice Management System

EMR/EHR software

Job description

OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases. Our team is bringing together leaders to the market place to help drive OneOncology’s mission and vision. Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, urology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of independent physicians and the patients they serve.

Job Description: Role Summary:

The Claims Corrections Specialist will report to OneOncology’s RCM Manager. This role is responsible for making corrections to any charges that are not posted correctly or that are not associated with the correct insurance. The Claims Corrections Specialist is also responsible for correcting incorrect payments, adjustments, billing errors and identifying issue trends.

Responsibilities:

• Update charges within the Practice Management system due to primary insurance changes, billing errors and/or payment errors.
• Reappoint charges related to secondary or tertiary insurance changes.
• Resolve file rejections from payers in a timely manner.
• Work tasks related to Insurance changes and denials promptly.
• Interpret Insurance payments, denials, and reprocesses from explanation of benefits.
• Submit Corrected Claims following payer guidelines as it relates to insurance denials.
• Work and track assigned projects as instructed by RCM Manager.
• Maintain documentation and tracking mechanisms related to errors and insurance changes.
• Work closely with RCM Manager and RCM teams to maintain excellent communication and efficient workflows.
• Other duties as assigned by the RCM Manager.
• Additional responsibilities as assigned to help drive our mission of improving the lives of everyone living with cancer.

Qualifications:

• High School diploma or equivalent required
• One year of experience in directly related role preferred.
• Two years cash posting and/or medical billing experience in a physician practice setting required.

Essential Competencies:

• Knowledge of medical billing, HCPCS, CPT and ICD codes
• Broad knowledge of Revenue Cycle Management.
• Alpha Numeric data entry experience with speed and accuracy.
• Ability to work in a production environment accurately achieving performance objectives.
• Proficient in the use of end-user computer applications regarding productivity (MS Word, Excel, Outlook), billing and other medical information systems.
• Ability to operate various types of office equipment.
• Ability to work effectively with all levels of management and other colleagues, demonstrating initiative and mature judgment.
• Excellent customer service skills.
• Effective verbal and written communications, including active listening skills and skills in presenting findings and recommendations.
• Attendance is an essential job function.

This job description does not contain a full listing of activities, duties or responsibilities required of this role. Duties, responsibilities and activities may change, or new ones may be assigned at any time with or without notice.

#LI-REMOTE

OneOncology was founded by community physicians, for community physicians, with the mission of improving the lives of everyone living with cancer and other diseases. Our goal is to enable community medical practices to remain independent and to improve patient access to care in their communities, all at a lower cost than in the hospital setting. OneOncology supports our platform of community medical practices through group purchasing, operational optimization, practice growth, and clinical innovation. Our partner practices comprise approximately 2,300+ providers who care for approximately 1.5 million patients across 20 states.