Accounts Receivable Insurance Specialist

POSITION SUMMARY The Accounts Receivable Insurance Specialist handles insurance follow-up and account resolution for assigned payors to ensure timely reimbursement. Responsibilities include resolving billing issues, researching discrepancies, and addressing patient inquiries with a focus on service and communication. This role requires expertise in the revenue cycle, medical billing, and oncology-specific reimbursement guidelines. Description The Accounts Receivable Insurance Specialist handles insurance follow-up and account resolution for assigned payors to ensure timely reimbursement. Responsibilities include resolving billing issues, researching discrepancies, and addressing patient inquiries with a focus on service and communication. This role requires expertise in the revenue cycle, medical billing, and oncology-specific reimbursement guidelines. Core Essential Responsibilities Manage accounts receivable for assigned payors by analyzing and resolving denials, appealing rejected claims, and correcting billing discrepancies to ensure timely reimbursement. Conduct consistent follow-up with insurance companies and address overdue claims across commercial and government payors. Review EOBs to confirm accurate payments and report discrepancies or trends to leadership. Maintain detailed documentation of collection efforts and resolution activities in EPIC using standard note format. Handle patient billing inquiries, negotiate payment plans, and respond promptly to calls or correspondence. Monitor and report credit balances; initiate appropriate refunds and write-offs with supporting documentation. Collaborate with internal teams to communicate billing issues, share updates, and support resolution. Verify patient insurance eligibility and benefits; understand payer-specific processes, including copays, deductibles, and coinsurance. Stay current on oncology coding standards (HCPCS/ICD-10/CPT) and participate in training and compliance initiatives. Support other revenue cycle functions as needed and perform additional duties as assigned. EDUCATION & EXPERIENCE High school diploma or equivalent required; associate degree in health sciences preferred. Minimum 3–5 years of experience in medical accounts receivable, with oncology/hematology billing preferred. At least 5 years’ experience in private practice accounts receivable. Knowledge, Skills Or Abilities Proficient in medical billing and insurance reimbursement processes, including denial resolution and payer-specific guidelines. Thorough understanding of ICD-10, CPT required and working knowledge of HCPCS and modifiers specific to hematology/oncology treatments preferred. Proficient in using Epic or similar programs. #J-18808-Ljbffr Cancer Center of South Florida