Healthcare Eligibility & Benefits Specialist

US Oncology Inc.; Ocala (FL); On-site; USD 38,000 - 52,000; Full time

Benefits offered by this job

Medical

Dental

Vision

Life Insurance

Short-term disability

Long-term disability

PTO

401k with match

Wellness program

Tuition Reimbursement

Employee Assistance Program

Retail discounts

Job summary

US Oncology Inc. is seeking a detail-oriented specialist to resubmit invoices and resolve eligibility variances while coordinating referrals and pre-authorizations. You will work with clinics to verify coverage and patient responsibility.

The role requires attention to documentation, HIPAA compliance, and the ability to handle complex payor interactions in a fast-paced oncology setting.

Qualifications

• High school diploma or equivalent required.
• Associates degree preferred.
• Three years with front desk, registrations, healthcare benefits or equivalent experience.
• Proficiency with computer systems and Microsoft Office (Word and Excel) required.

Responsibilities

• Researches and obtain accurate and current insurance coverage information and updates PMS.
• Evaluate benefits and eligibility to assess patient financial responsibility.
• Coordinate referrals and ensure appropriate authorizations are entered into the PMS.
• Identify uninsured patients and refer to patient benefit representative.
• Communicate system issues and payor trends to supervisor.
• Answer questions and resolve complaints when needed.
• Document conversations with payors in the PMS.
• Follow up on missing or incomplete documentation with clinics.
• Work ETM and TES edits as required.
• Manage complex payor eligibility and referrals.
• Research and respond to routine account inquiries and escalate non-routine issues.
• Identify processes to improve efficiencies and workflows.
• Adhere to confidentiality and HIPAA compliance.

Skills

Microsoft Office

Front desk experience

Healthcare benefits

Registrations

Education

High School Diploma or equivalent

Associate’s degree preferred

Tools

PMS (practice management system)

Job description

US Oncology Inc. is seeking a detail-oriented specialist to resubmit invoices and resolve eligibility variances while coordinating referrals and pre-authorizations. You will work with clinics to verify coverage and patient responsibility.

The role requires attention to documentation, HIPAA compliance, and the ability to handle complex payor interactions in a fast-paced oncology setting.