AR Specialist in Oncology

Role & responsibilities

Responsibilies:

• Demonstrates thorough understanding of the accounts receivable functions; compliant with federal and applicable state regulations and our organization's policy and procedures.
• Daily works assigned insurance accounts receivable AR work queues within Veradigm Pro PM.
• Identifies payer trends and/or claim submission issues and reports to assigned AR Manager immediately.
• Works credit balance AR and prepares refund requests and/or posting error corrections in an effort to resolve credit balances timely. (line item, claim level and/or account level credit balances)
• Submits written appeals to insurance carriers when applicable and ensures timely follow-up regarding status.
• Maintains tickler file via AR work queues in Veradigm Pro PM and ensures timely follow-up of outstanding claims/balances.
• Daily utilizes the Client Communication Log (CCL) per client ensuring timely responses from client for resolution.
• Maintains working day to day knowledge of the practice management system. (Veradigm Pro PM and Practice EDI Insight).
• Maintains strong working knowledge of Radiation Oncology coding or the specific specialty in which the accounts receivable is assigned.
• Ensures strong communication with management and team members.
• Ensures compliance with appropriate industry regulations and state and federal regulations.
• Maintains working knowledge of applicable laws and regulations as they relate to assigned responsibilities.
• Maintains confidentially of all information related to patients, medical staff, finances and cost effective health care delivery issues.
• Strives to achieve and maintain company Days Sales Outstanding (DSO) and Account Receivable aging standards. (Company benchmarks/KPIs)
• Demonstrates the ability to work well with peers while ensuring a strong cohesive team.