Insurance AR Specialist

OneOncology; United States; On-site; USD 50,000 - 65,000; Full time

Job summary

OneOncology is seeking an Insurance AR Specialist to manage accounts receivables and insurance claims. This role requires expertise in medical billing and collections, especially within the oncology field. The successful candidate will collaborate with patients and insurance providers to ensure timely payments. Requirements include a high school diploma, strong analytical skills, and previous experience in medical collections. Join us to improve the lives of those living with cancer in the United States.

Qualifications

• 3+ years of experience in medical collections, ideally in oncology.
• Strong understanding of HCPCS, CPT, and ICD codes.
• Ability to communicate effectively both verbally and in writing.

Responsibilities

• Manage accounts and follow up on collections activities.
• Evaluate and prioritize collection actions for outstanding balances.
• Work closely with insurance companies for claims resolution.

Skills

Billing knowledge

Customer service skills

Analytical skills

Multi-tasking

Communication skills

Education

High school diploma

Bachelor’s degree

Tools

MS Word

Excel

Outlook

Job description

OneOncology is positioning community oncologists to drive the future of cancer care through a patient‑centric, physician‑driven, and technology‑powered model to help improve the lives of everyone living with cancer. Our team is bringing together leaders to the marketplace 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, 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 community oncologists and the patients they serve.

Job Description

The Insurance AR Specialist reviews monthly accounts receivables, follow up for resolution, insurance contact and claim re‑files when necessary. They are 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 related to proton therapy, radiation therapy, and radiology 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.

ESSENTIAL FUNCTIONS

• 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.

KNOWLEDGE, SKILLS & ABILITIES

• Attendance is an essential job function.
• Detailed knowledge of billing, HCPCS, CPT and ICD codes.
• Previous commercial collections experience preferred.
• Ability 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 skills.
• Skill 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.

EDUCATION & EXPERIENCE

• High school diploma or equivalent required.
• Bachelor’s degree preferred.
• Minimum of 3 years of experience in medical collections required, preferably in an Oncology healthcare setting.
• Radiation Oncology/Proton experience a plus.
• Expertise in insurance policies and regulations related to medical billing, including Medicare and Medicaid.