Insurance Specialist II

Overview

The US Oncology Network is looking for an Insurance Specialist to join our team at Texas Oncology. This full‑time hybrid position will support the Radiation Department at 3001

E. President George Bush Hwy Suite 100 in Richardson, Texas. Typical work week is Monday through Friday, 8:30 a.m. – 5:00 p.m.

As part of The US Oncology Network, Texas Oncology delivers high‑quality, evidence‑based care to patients close to home. Texas Oncology is the largest community oncology provider in Texas with approximately 530 providers across 280+ sites. Our mission is to use leading‑edge technology and research to deliver high‑quality, evidence‑based cancer care for patients.

• Monitors delinquent accounts and performs collection duties.
• Reviews reports, researches and resolves issues.
• Reviews payment postings for accuracy and ensures 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.
• May refer patients to the Patient Benefits Representative to set up payment plans.
• Maintains credit balances of patients and payors, ensuring timely refunds within government guidelines and regulations.
• Adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regard to patient records.
• Performs other duties as requested or assigned.

• Level 1
  • High School diploma or equivalent required.
  • Minimum two (2) years combined medical billing and payment experience required.
  • Demonstrate knowledge of state, federal, and third‑party claims processing.
  • Demonstrate knowledge of state and federal collections guidelines.
  • Must successfully complete required e‑learning courses within 90 days of occupying position.
• Level 2 (in addition to Level 1 requirements)
  • Minimum four (4) years combined medical billing and payment experience required.
  • Demonstrate knowledge of medical coding, preferably oncology coding.
• Level Sr (in addition to Level 1 and 2 requirements)
  • Associate’s degree in Finance, Business or four‑year revenue cycle experience preferred.
  • Minimum two (2) years insurance resolution experience resolving issues with patients and payers as well as four (4) years combined medical billing and payment experience required.
  • Proficiency with computer systems and Microsoft Office (Word and Excel) required.
  • Demonstrate knowledge of oncology medical coding.
  • Demonstrate knowledge of state, federal, and third‑party claims processing required.

• 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.
• 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 oriented.
• Demonstrates positive interpersonal relations in dealing with fellow employees, supervisors, physicians, patients, and outside contacts.
• 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.

The physical demands involve sitting and manipulating a computer keyboard and mouse, standing, walking, and reaching with hands and arms. The employee may occasionally lift or move up to 30 pounds. Requires vision and hearing corrected to normal ranges. Work is performed in an office environment with frequent contact with staff and patients.