Oncology Insurance Eligibility Specialist (Hybrid Remote)

US Oncology Network-wide Career Opportunities; Richardson (TX); Hybrid; USD 42,000 - 62,000; Full time

Job summary

The US Oncology Network is seeking an Insurance Specialist I to join Texas Oncology in a full-time hybrid remote role supporting the Central Business Office. The position can be level 1, 2, or Sr depending on experience and commutable distance to the office.

You will analyze eligibility variances, resubmit invoices, coordinate referrals and retro-authorizations, and support patient benefits coordination while ensuring HIPAA compliance and accurate PMS data entry.

Qualifications

• High school diploma or equivalent required.
• 0–2 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; makes corrections in the PMS.
• May evaluate benefits and eligibility to assess patient financial responsibility.
• May coordinate referral from primary care to ensure approvals are secured and entered into the PMS.
• Identifies uninsured patients and refers to patient benefit representative for coordination of payment.
• Communicates system issues and/or payor trends to leader or 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 TES Edits.
• Responds to routine account inquiries and escalates non-routine issues as needed.
• Adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regards to patient records and collections.
• Other duties as requested or assigned.

Skills

Front desk experience

Healthcare benefits

Data entry

Customer service

Education

High school diploma or equivalent

Associates degree preferred

Tools

PMS

Microsoft Office (Word/Excel)

Job description

The US Oncology Network is seeking an Insurance Specialist I to join Texas Oncology in a full-time hybrid remote role supporting the Central Business Office. The position can be level 1, 2, or Sr depending on experience and commutable distance to the office.

You will analyze eligibility variances, resubmit invoices, coordinate referrals and retro-authorizations, and support patient benefits coordination while ensuring HIPAA compliance and accurate PMS data entry.