Insurance Specialist II

Overview Insurance Specialist required to support the Medical Oncology Department at Texas Oncology, located at 8501 N. Mopac Suite 310, Austin, Texas. Full‑time, Monday through Friday, 8:00 a.m. to 5:00 p.m. Responsibilities 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 account status. Recommends accounts for collection or write‑off. Contacts patients to secure past‑due balances, verifies patient demographics, 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. Adheres to confidentiality, state, federal, and HIPAA laws and guidelines regarding patient records. Performs other duties as requested or assigned. Qualification Levels Level 1 High School diploma or equivalent required. Minimum two (2) years combined medical billing and payment experience required. Demonstrates knowledge of state, federal, and third‑party claims processing. Demonstrates knowledge of state and federal collections guidelines. Must successfully complete required e‑learning courses within 90 days of occupying the position. Level 2 Minimum four (4) years combined medical billing and payment experience required. Demonstrates knowledge of medical coding, preferably oncology coding. Level Sr Associate’s degree in Finance, Business or four years 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. Demonstrates knowledge of oncology medical coding. Demonstrates knowledge of state, federal, and third‑party claims processing required. 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 colleagues, supervisors, physicians, patients, and outside contacts to maximize productivity and positive relationships. 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 employee is required to sit and use hands to manipulate a computer keyboard and mouse regularly. 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. Vision and hearing corrected to normal ranges may be required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work Environment Work is performed in an office environment with frequent contact with staff. The employee may be exposed to direct contact with patients with potential for exposure to blood, toxic substances, ionizing radiation, and other conditions common to a clinic environment. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. #J-18808-Ljbffr The US Oncology Network