Insurance Specialist

Insurance Specialist

Join RCCA as an Insurance Specialist - Make a Meaningful Impact Every Day

Are you detail-oriented, driven, and passionate about making a difference in healthcare? RCCA is looking for an Insurance Specialist to help ensure our patients receive the care they need without financial barriers. In this vital role, you'll be at the heart of our revenue cycle operations, helping maintain accurate and timely account resolutions.

Employment Type : Full Time

Location : Hackensack, NJ

Compensation : $19.50 - $26.29 per 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

Competencies

Uses Technical and Functional Experience

Possesses up to date knowledge of the profession and industry

Accesses and uses resources when appropriate

Demonstrates Adaptability

Handles day to day work challenges confidently

Is willing and able to adjust to multiple demands, shifting priorities, ambiguity, and rapid change

Shows resilience in the face of constraints, frustrations, or adversity

Demonstrates flexibility

Demonstrates positive interpersonal relations in dealing with fellow employees, supervisors, physicians, patients as well as outside contacts so that productivity and positive employee / patient relations are maximized.

Uses Sound Judgment

Makes timely, cost effective, and sound decisions

Makes decisions under conditions of uncertainty

Shows Work Commitment

Sets high standards of performance

Pursues aggressive goals and works efficiently to achieve them

Commits to Quality

Emphasizes the need to deliver quality products and / or services

Defines standards for quality and evaluates products, processes, and services against those standards

Manages quality

Improves efficiencies

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.

The US Oncology Network is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.