Insurance Representative

Description

Join a mission-driven oncology clinic where your expertise helps patients navigate their care with clarity and compassion.

We are seeking a dedicated Insurance Representative who thrives in a fast-paced medical environment and takes pride in removing financial barriers for patients during some of life's most challenging moments. If you're detail-oriented, patient-focused, and ready to make a meaningful impact every day, we encourage you to apply.

Highlands Oncology began in 1996 with three physicians and a desire to change the face of oncology care in our community. Dr. Malcolm Hayward, Dr. Dan Bradford, and Dr. Thad Beck knew that patients do better at home, in the community where they live and work, and where their support system is already in place. In furthering that goal, Highlands has grown with the region from a single location 26 years ago, to 6 locations in Northwest and Northcentral Arkansas today employing more than 850 diverse team members.

As Northwest Arkansas continues to grow, so must the services and providers available in the region. Highlands Oncology is committed to remaining on the cutting edge to ensure our community has access to the very best cancer care. What we have is something quite unique right here in our own backyard with a caring multidisciplinary team focused on treating patients like family.

Job Summary:

The Insurance Representative is responsible for analyzing, investigating, following up on denied and/or underpaid claims, as well as patient balances, to facilitate payment and resolution with patient accounts.

Job Duties / Responsibilities:

• Review claim issues to determine the accuracy of reimbursement payments.
• Provide medical records and/or other requests to substantiate payment of claims to insurance payers.

• Review and resolve assigned tasks in the Unity/Centricity queue.
• Able to organize and prioritize tasks to complete all work assigned in a timely manner.
• Routinely monitors all high balance accounts to ensure follow up activity.
• Develops monthly action plans to lower A/R and increase cash flow.
• Answer all patient calls professionally to help to resolve any claims or billing questions.
• Informs departmental leadership of any insurance related issues of importance.
• Maintains patient and clinic confidentiality and adheres to clinical standards, policies, & procedures.

• Maintain a professional relationship with physician teams.
• Maintain pleasant/helpful attitude towards patients and staff.
• Perform all related duties as required by Revenue Cycle Manager(s), Business Office Director, CFO, and CEO.

Requirements

Required Skills/Abilities:

• Knowledge of billing policies and regulations
• Knowledge of g4/PM System, Onbase, and Availity.
• Knowledge and experience with CPT, ICD-10-CM, HCPCS codes and EMR systems.
• Knowledge of medical terminology and medical oncology treatment course.
• Knowledge of Medicare guidelines and coverage determinations (LCD, NCD, etc.).
• Ability to adapt to changing billing requirements by CMS.
• Understanding of claims appeal process.
• Ability to work in MS Office environment.
• Ability to handle multiple and conflicting priorities.
• Ability to work independently and collaboratively within a team environment.

• Ability to maintain good working relationships.
• Demonstrates attention to detail.
• Demonstrates professionalism in appearance/dress code.

Certifications/Licenses/Education/or Experience in a related field:

• High School Diploma or equivalent.
• Minimum of 1-2 years of medical office experience, preferred.
• Insurance and billing experience preferred.

Physical Requirements:

• Will require extensive desk use and computer use.
• Long periods of sitting.
• Moderate walking, bending, squatting within the scope of normal office functions.
• Light lifting may be required of up to 25 pounds.

Work Environment:

• The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job. Reasonable accommodation may be made to enable individuals with disabilities to perform essential functions.
• Due to the nature of our business and the use of radiation and hazardous chemicals, it is imperative that all employees foster a culture and environment of safety.
• Safety Sensitive: In accordance with Arkansas code this position is designated as a safety sensitive position wherein the employee performing the job duties under the influence may constitute a threat to health or safety.