Insurance Specialist

Overview

Regional Cancer Care Associates (RCCA) is seeking a detail-oriented and motivated Insurance Specialist to join our growing team. In this vital role, you will help ensure patients receive the care they need by supporting accurate billing, timely payments, and exceptional service.

Employment Type: Full Time

Location: Teaneck, NJ (Remote)

Compensation: $18.99 - $29.22 hour

Compensation packages based on your unique skills, experience, and qualifications

As of the date of this posting, RCCA offers a comprehensive benefits package for this position, subject to eligibility requirements. In addition to the salary, we provide: Health, dental, and vision plans, Wellness program, Health savings account - Flexible spending accounts, 401(k) retirement plan, Life insurance, Short-term disability insurance, Long-term disability insurance, Employee Assistance Program (EAP), Paid Time Off (PTO) and holiday pay, Tuition discounts with numerous universities.

We believe these benefits underscore our commitment to the well-being and professional growth of our employees.

Responsibilities

• Monitors delinquent accounts and performs collection duties
• Reviews reports, identifies denied claims, researches and resolves issues, may perform a detailed reconciliation of accounts, and resubmits claim to payer
• Reviews payment postings for accuracy and to ensure account balances are current
• Works with co-workers to resolve payment and billing errors
• Monitors and updates delinquent accounts status
• Recommends accounts for collection or write-off
• Verifies existing patients have necessary referral and/or authorization documentation prior to examination date
• Contacts and follows up with patient’s physician for any missing or incomplete documentation
• Contacts patients to secure past due balances, verifies patient demographics and insurance providers, updates information in systems, and documents conversations
• Answers patient payment, billing, and insurance questions and resolves complaints
• May refer patients to Patient Benefits Representative to set up payment plans
• Contacts third party payors to resolve payor issues, expedite claim processing, and maximize medical claim reimbursement
• Maintains credit balances of patients and payors ensuring timely refunds within government guidelines/regulations
• Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regard to patient records
• Performs other duties as requested or assigned

Qualifications

• High School diploma or equivalent required
• Minimum four (4) years combined medical billing and payment experience required
• Demonstrate knowledge of medical coding, preferably oncology coding
• Demonstrate knowledge of state, federal, and third party claims processing required
• Demonstrate knowledge of state & federal collections guidelines
• Must successfully complete required e-learning courses within 90 days of occupying position

PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be offered to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. The position requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. The position requires standing and walking for extensive periods of time. The employee occasionally lifts and carries items weighing up to 40 lbs. The position requires corrected vision and hearing to normal range.

WORK ENVIRONMENT
The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites.

• High School diploma or equivalent required
• Minimum four (4) years combined medical billing and payment experience required
• Demonstrate knowledge of medical coding, preferably oncology coding
• Demonstrate knowledge of state, federal, and third party claims processing required
• Demonstrate knowledge of state & federal collections guidelines
• Must successfully complete required e-learning courses within 90 days of occupying position

PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be offered to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. The position requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. The position requires standing and walking for extensive periods of time. The employee occasionally lifts and carries items weighing up to 40 lbs. The position requires corrected vision and hearing to normal range.

WORK ENVIRONMENT
The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites.

• Monitors delinquent accounts and performs collection duties
• Reviews reports, identifies denied claims, researches and resolves issues, may perform a detailed reconciliation of accounts, and resubmits claim to payer
• Reviews payment postings for accuracy and to ensure account balances are current
• Works with co-workers to resolve payment and billing errors
• Monitors and updates delinquent accounts status
• Recommends accounts for collection or write-off
• Verifies existing patients have necessary referral and/or authorization documentation prior to examination date
• Contacts and follows up with patient’s physician for any missing or incomplete documentation
• Contacts patients to secure past due balances, verifies patient demographics and insurance providers, updates information in systems, and documents conversations
• Answers patient payment, billing, and insurance questions and resolves complaints
• May refer patients to Patient Benefits Representative to set up payment plans
• Contacts third party payors to resolve payor issues, expedite claim processing, and maximize medical claim reimbursement
• Maintains credit balances of patients and payors ensuring timely refunds within government guidelines/regulations
• Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regard to patient records
• Performs other duties as requested or assigned