Insurance Claims Specialist - Denials & Resolution

The US Oncology Network; Antioch (CA); On-site; USD 33,000 - 44,000; Full time

Job summary

The US Oncology Network in Antioch, CA is seeking an Insurance Claims Follow-Up specialist responsible for investigating aged insurance claims and determining appropriate action for resolution. You will analyze payment status using health plan resources and maintain detailed documentation in the practice’s systems.

The role requires multitasking, teamwork, and timely rebilling or appealing within carrier filing limits.

Qualifications

• High School diploma or equivalent is required.
• 2 years in Business Admin, Healthcare, or related field preferred.
• CMRS and CMIS certifications preferred.
• 1–2 years billing in medical office/hospital required.
• 1–2 years CPT/ICD-10 guidelines and modifiers required.
• 1 year Excel and MS Office applications required.
• 1-year EMR knowledge required.
• 1–2 years EPIC EMR experience preferred.
• 1–2 years Division of Financial Responsibility (DoFR) experience preferred.

Responsibilities

• Follow up on insurance claims to ensure timely resolution.
• Maintain documentation of claims and collections activities.
• Contact insurance companies to resolve payment issues.
• Meet daily AR targets (35–40 claims).
• Collaborate with leadership to improve processes and provide insights.
• Maintain spreadsheets assigned by Supervisor.
• Use EPIC EMR and EPIC WQs for claims processing.

Skills

MS Office

Teamwork

Education

High School diploma or equivalent

CMRS

CMIS

Tools

EPIC EMR

Job description

The US Oncology Network in Antioch, CA is seeking an Insurance Claims Follow-Up specialist responsible for investigating aged insurance claims and determining appropriate action for resolution. You will analyze payment status using health plan resources and maintain detailed documentation in the practice’s systems.

The role requires multitasking, teamwork, and timely rebilling or appealing within carrier filing limits.