Medical Insurance Specialist

Overview

Job: Medical Insurance Specialist

Hours: Monday - Friday, 8:00 – 4:30 p.m. or 8:30 - 5:00 p.m. (100% onsite position)

Pay Range: $22.87 - $28.60 an hour. The actual hiring rate may vary based on several factors, including your previous work experience, educational background, the responsibilities of the position, and demonstrated performance. These elements help us ensure a fair and competitive offer aligned with your qualifications and the role's requirements.

Benefits: We offer a competitive benefits package that includes medical, dental, vision, life insurance, short-term and long-term disability coverage, generous PTO, an employer match 401K plan, a wellness program, tuition reimbursement, an employee assistance program (EAP), and retail discounts.

Job Summary: Shenandoah Oncology is looking for a Medical Insurance Specialist that will embody our core values, The RETIC Way:
Respect, Excellence, Teamwork, Integrity, and Compassion. Under general supervision, the individual will be responsible for managing payer and patient accounts to ensure balances are paid accurately and on time, maintaining current account status. Actively performs collection activities by monitoring delinquent accounts, engaging with patients to facilitate payment, resolving billing issues, and responding to both routine and complex account inquiries. Adheres to established procedures and guidelines to complete tasks efficiently, supporting accurate financial operations and a positive service experience.

• 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 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 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 other duties as requested or assigned

• 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 required
• Demonstrate knowledge of state & federal collections guidelines
• Must successfully complete required e-learning courses within 90 days of occupying position

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. Involves frequent contact with staff. While performing the duties of this job, the employee is regularly exposed to direct contact with patients with potential for exposure to blood, toxic substances, ionizing radiation and other conditions common to a clinic environment.