Medical Claims Resolution Specialist II

American Oncology Network; Macon (GA); On-site; USD 37,000 - 58,000; Full time

Job summary

American Oncology Network is seeking a Medical Billing Specialist to review insurance claims, resolve inquiries and denials, and secure timely payments. You will liaise with insurance carriers to research balances and respond with supporting documentation, following SOPs and HIPAA rules.

The role requires 1 year in medical billing/collections, CPT/ICD code knowledge, and EMR proficiency (GE Centricity preferred). On-site in Central Georgia with a competitive pay range.

Qualifications

• High school diploma or GED required.
• At least 1 year of medical billing/collections experience.
• Strong knowledge of insurance billing and CPT/ICD codes.
• In-depth understanding of explanation of benefits (EOB).
• Experience with EMR systems, GE Centricity preferred.
• Knowledge of Oncology/Hematology or related imaging/specialties.
• Excellent communication and interpersonal skills.
• Ability to work independently or in a team; adhere to HIPAA.

Responsibilities

• Maximize reimbursements through accurate billing and collections.
• Respond to inquiries about outstanding balances and payments.
• Manage claim denials with documentation to support appeals.
• Coordinate with office staff and clinicians as needed.
• Report recurring denials or issues to the payer and supervisor.
• Address contract discrepancies and follow SOPs.
• Attend payer meetings and trainings as required.
• Document all collection activity in EMR systems.
• Maintain patient confidentiality per HIPAA and company policies.

Education

High School Diploma or GED

Tools

Centricity Practice Management

Onco EMR

Unity

Job description

American Oncology Network is seeking a Medical Billing Specialist to review insurance claims, resolve inquiries and denials, and secure timely payments. You will liaise with insurance carriers to research balances and respond with supporting documentation, following SOPs and HIPAA rules.

The role requires 1 year in medical billing/collections, CPT/ICD code knowledge, and EMR proficiency (GE Centricity preferred). On-site in Central Georgia with a competitive pay range.