The US Oncology Network · 18 hours ago
Revenue Cycle Specialist
Florida, United States
Full-time
Onsite
Mid Level
$21.38/hr - $44.40/hr
3+ years expThe US Oncology Network is a healthcare organization seeking a Revenue Cycle Specialist to manage billing and collections from assigned payors. The role involves ensuring compliance with regulatory requirements, handling inquiries from insurance carriers, and resolving account issues to achieve reimbursement.
CommunitiesHealth CareMedicalOncologyTest and Measurement
Responsibilities
Respond to inquiries from insurance carriers, via telephone, email or fax and demonstrate a high level of customer service
Pursue reimbursement from carriers by placing phone calls and documenting all communication in Athenahealth to ensure progress is made on outstanding accounts
Identify and respond to patterns of denials or trends and perform complex account investigation as needed to achieve resolution
Review and resolve uncollected accounts and prepare charge corrections
Appeal carrier denials through review of coding, contracts, and medical records
Call insurance companies regarding any discrepancy in payments if necessary
Identify and bill secondary or tertiary insurances
Research and appeal denied claims
Set up patient payment plans
Verify patient benefit eligibility/coverage and research ICD-10 diagnosis and CPT treatment codes as needed
Advise management of any trends regarding insurance denials to identify problems with payers
Complete required reports and assist with special projects as assigned
Qualification
Required
High School Diploma or General Education Degree (GED) with 3 years prior hands-on experience in a fast-paced medical billing environment
Must have previous experience in a healthcare setting
Familiarity with CPT and ICD-10 is also required
Strong communication, including writing, speaking and active listening
Great customer service skills, including interpersonal conversation
Good problem-solving and critical thinking skills
Organization, time management and prioritization abilities
Ability to be discreet and maintain the security of patient or customer information
Effective computer skills with practice management software
Understanding of industry-specific policies, such as HIPAA regulations for health care
Knowledge of insurance guidelines, including HMO/PPO, Medicare, and state Medicaid
Knowledge of HMO/PPO, Medicare, Medicaid, and other payer requirements and systems
Effective communication abilities for phone contacts with insurance payers to resolve issues
Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members
Able to work in a team environment
Problem-solving skills to research and resolve discrepancies, denials, appeals
Knowledge of medical terminology
Knowledge of CPT/ICD-10 and modifier coding
Preferred
CPC certification is a plus
Company
The US Oncology Network
Every day, The US Oncology Network helps approximately 3,300 providers deliver value-based, integrated care for patients—close to home.
10001+ employees
Funding
Current Stage
Late StageTotal Funding
unknown2010-12-30Acquired
Leadership Team
R. Steve Paulson
National Policy Board Executive Committee
Recent News
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