Oncology Insurance Specialist

Position Insurance Specialist Location Cincinnati, OH (Wooster Road office; remote transition planned) Hours 40 hours per week Overview OHC – Specialists in Cancer and Blood disorders – is seeking a full‑time insurance specialist to work from our Wooster Road office in Cincinnati, Ohio. This position will transition to a remote schedule. As the only independent adult cancer program in the region, we offer Medical, Radiation, Blood and Marrow Transplant, Gynecologic, and Breast Surgical Oncology services. OHC supports a robust cancer research and clinical trials program, neuro‑oncology, cancer genetics specialists, and a supportive care program. The Insurance Specialist handles all radiation‑related billing, including authorizations, clinical coordination, delinquent accounts, payment and billing errors, and collections. OHC has been fighting cancer on the front lines for more than 38 years. We are now one of the nation’s largest independent oncology practices and the region’s premier source of treatment for nearly every form of adult cancer and complex blood disorder. At its heart, our approach to cancer care is simple – to surround our patients with everything they need so they can focus on what matters most: beating cancer! Benefits Life insurance, vision insurance, paid holidays, long‑term disability, tuition reimbursement, 401(k), profit sharing. Why choose OHC? 3 Health Insurance Plans to choose from 2 Dental and 2 Vision insurance plans A company‑matched 401(k) plan Profit sharing plan for clinical employees Competitive salaries Company‑paid short‑term / long‑term disability / life insurance Paid holidays A generous PTO plan Tuition Reimbursement Professional Development Program Nationwide discounts at hotels, resorts, and retailers for OHC employees Wellness Program Yearly merit raises Opportunities for advancement 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 account 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 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 HIPAA laws and guidelines with regard to patient records Performs radiation authorization and clinical coordination Reviews radiation oncology treatment plans and supporting documentation Secures authorization prior to CT simulation and treatment start Coordinates urgent/same‑day treatment start cases Collaborates with physicians, dosimetry, scheduling, and radiation teams Monitors authorization validity across multi‑fraction treatment courses Manages radiation‑specific peer‑to‑peer reviews, reconsiderations, and appeals Escalates cases that place treatment timelines at risk Performs other duties as requested or assigned Qualifications High school diploma or equivalent required Minimum two (2) years medical billing and payment experience in oncology required Demonstrated knowledge of state, federal, and third‑party claims processing required Demonstrated knowledge of state & federal collections guidelines required Must successfully complete required e‑learning courses within 90 days of occupying the 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 Customer service orientation Demonstrates positive interpersonal relations in dealing with fellow employees, supervisors, physicians, patients, and 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 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 will be offered to enable individuals with disabilities to perform the essential functions. Work is performed in an office environment. It involves frequent contact with staff. While performing the duties of this job, the employee is regularly exposed to direct contact with patients with potential exposure to blood, toxic substances, ionizing radiation, and other conditions common to a clinic environment. #J-18808-Ljbffr