Insurance Specialist

Job Overview

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.

Base pay range: $19.50/hr - $26.29/hr.

Pay range is provided by Regional Cancer Care Associates. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

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. Benefits include 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.

• 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 account 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.

• 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.

• 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.

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