American Oncology Network · 1 month ago
Claims Resolution Specialists II
Macon, GA
Full-time
Onsite
Entry Level
$15.83/hr - $26.38/hr
1+ years expAmerican Oncology Network is seeking a Claims Resolution Specialist II to manage medical insurance claims and ensure appropriate payment. The role involves resolving inquiries and denials, contacting insurance carriers, and maintaining accurate documentation while adhering to healthcare regulations.
Health CareHealth DiagnosticsMedicalOncology
Responsibilities
Review medical insurance claims for resolution and to obtain appropriate payment thru outlined processes
Resolve incoming inquiries, denials and correspondence from various entities to obtain appropriate resolution and payment in timely manner
Contact insurance carriers to research, compile and respond on open account balances to obtain appropriate payments
Apply billing/collection knowledge required for insurance payers to insure proper and maximum reimbursement
Respond to patient and office inquiries regarding outstanding insurance balances, insurance payments received, allowable charges, assignment of benefits and any other insurance questions
Manage insurance review and denial of payment by responding with appropriate documentation to support appeal
Follow-up on claim to ensure payment was received
Coordinate effort with office personnel and/or the doctor as necessary
Report any consistent claim denials or problems to appropriate team lead per payer
Inquire about and resolve any payments that differ from established profile on our payer contracts
Attend third party payer meetings, seminars, and training sessions and report any changes or concerns to your supervisor
Follow-up on correspondence in a timely manner
Transfer appropriate balances to patient responsibility per SOP and notify the patient and appropriate department of this action accordingly
Bill applicable secondary insurance
Document all collection activity in Onco EMR, Centricity and Unity
Contact patients to correct insurance information to ensure accuracy as needed
Maintain and ensure the confidentiality of all patient and employee information at all times as established by HIPPA and Company policies
Keep work area and records in a neat and orderly manner
Maintain all company equipment in a safe and working order
Will be expected to work at any Company location to help meet the Company’s business needs
Must establish and maintain effective work relationships with new and existing customers through a high degree of professionalism and excellent interpersonal communication skills
Will be expected to complete additional reports or projects as assigned by management
Comply with all Federal and State laws and regulations pertaining to patient care, patients’ rights, safety, billing, human resources and collections
Adhere to all Company and departmental policies and procedures, including IT policies and procedures and Disaster Recovery Plan
Qualification
Required
High School diploma or GED required
At least 1 year of prior work experience in the medical field, as well as experience in medical billing and/or collections
Must have excellent knowledge of insurance carrier billing and reimbursement with knowledge of medical terminology, ICD-9, ICD-10 and CPT codes
Must have an in-depth understanding of explanation of benefits (EOB)
Employee must be knowledgeable in Medical Oncology/Hematology and/or Radiation, Pathology, Radiology, Pumps and Specialties
Excellent communication and interpersonal skills are required
Employee must be able to work independently as well as in a team
Employee must complete 6 CEUs annually
Preferred
Electronic Medical Records (EMR), GE Centricity Practice Management software experience preferred
Company
American Oncology Network
American Oncology Network provides support and ancillary services for oncologist and cancer patients. It is a sub-organization of Cancer & Blood Specialists of Arizona.
1001-5000 employees
Funding
Current Stage
Public CompanyTotal Funding
unknown2023-09-20IPO
Leadership Team
Todd Schonherz
Chief Executive Officer and Board Member
David Afshar
Chief Financial and Operating Officer
Recent News
2026-01-06
2026-01-06
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