Oncology Claims Resolution Specialist
10 hours ago
We are seeking an experienced oncology claims resolution specialist with a strong background in US healthcare billing and collections. The ideal candidate should have at least 3 years of experience specifically in oncology AR, excellent communication skills, and the ability to handle complex claim resolutions while ensuring compliance with industry standards.
Key Responsibilities:- Contact insurance companies to follow up on oncology-related claims and resolve outstanding accounts receivable.
- Review and analyze denied or underpaid oncology claims and take corrective actions.
- Ensure timely follow-up on unpaid claims, resubmissions, and appeals.
- Collaborate with billing, coding, and clinical teams to address claim discrepancies.
- Maintain accurate documentation of all calls, claim status, and resolutions.
- Meet daily/weekly productivity and quality targets as per standards.
- Ensure compliance with HIPAA and healthcare regulations at all times.
- 3+ years of AR calling experience in US healthcare.
- Minimum 3 years of experience in Oncology billing & AR processes.
- Strong understanding of oncology-specific coding, modifiers, and payer guidelines.
- Excellent verbal and written communication skills with the ability to handle difficult conversations professionally.
- Knowledge of EOBs, remittance advice, and claims adjudication process.
- Ability to work independently in a remote setting and meet deadlines.
- Proficiency with healthcare billing software and MS Office tools.
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