Healthcare Eligibility & Care Coordination Specialist

US Oncology Network-wide Career Opportunities; Ocala (FL); On-site; USD 35,000 - 55,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

PTO

401k with company match

Wellness program

Tuition Reimbursement

Employee Assistance Program

Retailer Discounts

Job summary

US Oncology Network in Ocala, FL seeks a Billing/Eligibility Specialist to support the resubmission of invoices, verify insurance coverage, and resolve eligibility variances. You will coordinate referrals and retro-authorizations, maintain records in the Practice Management System, and ensure HIPAA and company compliance.

The role emphasizes accuracy, attention to detail, customer service, and collaboration with clinic staff to minimize denials and improve patient financial outcomes.

Qualifications

• High school diploma or equivalent; an associate degree is preferred.
• Three years of experience in front desk, registrations, healthcare benefits, or equivalent.
• Proficiency with computer systems and Microsoft Office (Word and Excel).

Responsibilities

• Researches and obtain accurate and current insurance coverage information, makes corrections in the PMS.
• May evaluate benefits and eligibility to assess patient financial responsibility.
• May coordinate referrals from primary care to ensure appropriate authorizations are secured and entered into the PMS.
• Identifies uninsured patients and refers to patient benefit representative for coordination of payment.
• Communicates system issues and payor trends to supervisor.
• May answer questions and resolve complaints.
• Documents conversations with payors in the PMS.
• Contacts and follows up with clinic or any missing or incomplete documentation.
• Works ETM and TES edits.
• Manages complex payor eligibility and referrals.
• Researches and responds to routine account inquiries and takes appropriate action; escalates non-routine issues, makes recommendations for solutions to unique situations.
• Identifies processes and procedures to improve efficiencies.
• Adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regards to patient\'s records and collections.

Skills

Front desk experience

Registrations experience

Healthcare benefits knowledge

Microsoft Office (Word, Excel)

Education

High school diploma or equivalent

Associate degree preferred

Tools

PMS (Practice Management System)

Job description

US Oncology Network in Ocala, FL seeks a Billing/Eligibility Specialist to support the resubmission of invoices, verify insurance coverage, and resolve eligibility variances. You will coordinate referrals and retro-authorizations, maintain records in the Practice Management System, and ensure HIPAA and company compliance.

The role emphasizes accuracy, attention to detail, customer service, and collaboration with clinic staff to minimize denials and improve patient financial outcomes.