Insurance Specialist II

Texas Oncology is looking for an Insurance Specialist II to join our team! This position will support the Radiation department with the Central Business Office location at 3001 East President George Bush Highway. This is a remote position, but the employee with still be required to go into our office for training and occasional meetings. Typical work schedule is Monday-Friday; 8:00am to 5:00pm.

Texas Oncology is the largest community oncology provider in the country and has approximately 600 providers in 220 sites across Texas and southeastern Oklahoma. Our founders pioneered community-based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission is still the same today-at Texas Oncology, we use leading-edge technology and research to deliver high-quality, high-touch, evidence-based cancer care to help our patients achieve "More breakthroughs. More victories." in their fight against cancer. Today, Texas Oncology treats half of all Texans diagnosed with cancer on an annual basis.

Why work for us?

Come join our team that is responsible for helping lead Texas Oncology in treating more patient diagnosed with cancer than any other provider in Texas. We offer our employees a competitive benefits package that includes Medical, Dental, Vision, Life Insurance, Short-term and Long-term disability coverage, a generous PTO program, a 401k plan that comes with a company match, a Wellness program that rewards you practicing a healthy lifestyle, and lots of other great perks such as Tuition Reimbursement, an Employee Assistance program and discounts on some of your favorite retailers.

What does the Insurance Specialist do?

The Insurance Specialist is responsible for payer account balances being paid timely and remaining current. Performs collection activities, such as monitoring delinquent accounts, resolving billing problems, and answering routine and non-routine account inquiries. Follows standard procedures and pre-established guidelines to complete tasks.

The essential duties and responsibilities:

• Monitors delinquent accounts and performs collection duties.
• Reviews reports, researches and resolves issues.
• Reviews payment postings for accuracy and to ensure account balances are current.
• Works with co-workers to resolve insurance payment and billing errors.
• Monitors and updates delinquent accounts status.
• Recommends accounts for collection or write-off.
• 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.
• 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.
• 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.

The ideal candidate for the position will have the following background and experience:

• High School diploma or equivalent required.
• Minimum four (4) years combined medical billing and payment experience required.
• 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.
• Demonstrate knowledge of medical coding, preferably oncology coding

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
• Customer Service
• 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 may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit and use hands to manipulate a computer keyboard and mouse. The employee is occasionally required to stand, walk, and reach with hands and arms. The employee must occasionally lift and/or move up to 30 pounds. Requires vision and hearing corrected to normal ranges.
  
  WORK ENVIRONMENT
  The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations maybe made to enable individuals with disabilities to perform the essential functions. Work is performed in an office environment. Involves frequent contact with staff. While performing the duties of this job, the employee is regularly exposed to direct contact with patients with potential for exposure to blood, toxic substances, ionizing radiation and other conditions common to a clinic environment.