Website Cancer Centers of Southwest Oklahoma

Under the direction of the Business director, the AR Specialist is responsible for the timely review of accounts receivable. During the review process, all aspects of insurance claims will be reviewed. This includes claim submission, errors, proper reimbursement, delayed payments and work toward resolving all issues to close the claim.

PREFERRED QUALIFICATIONS:
1. Basic computer skills and 10-key calculator.
2. Working knowledge of Microsoft Excel and spreadsheet manipulation.
3. Must have good organizational skills, reading, writing and proven communication skills.
4. Proficient math skills.
5. General office experience.
6. Two years of hospital/medical office billing and collections or can demonstrate an
understanding of hospital billing and collections

PRINCIPLE RESPONSIBILITIES:

Work Accounts Receivable lists for Medical and Radiation Oncology charges.
• Use Medicare software to update and reprocess claims and check claim status.
• Process appeals to insurances in a timely manner with specific medical documentation to support our service.
• Identify claim denial errors and correct claim to be reprocessed. Contact insurance companies as needed.
• Transfer claim balances appropriately.
• Update patient demographics and insurance as needed to resolve claim issues.
• Notify the business office manager of any trends in problems or underpayments.
• Participate in monthly review of accounts with the Business Director and COO.

Complete appeals and redeterminations for Mosaiq (CCSO Practice Management Software) claims.
• Review denials for possible appeals.
• Gather all related medical records to support our decision to use the medication.
• Work with the Medical Oncologist to write a detailed appeal letter for medical necessity.
• Track all appeal deadlines to ensure we submit in a timely manner.
• Follow appeal guidelines established by each insurance carrier.
• Communicate with Business Office Director on all unfavorable appeals.

Answer billing questions.
• Answer patient questions regarding their balance.
• Provide EOB’s to patients if they do not understand their balance.
• Refer patients to poster or business director if further explanations are needed.

Complete clerical tasks as needed.

Complete special projects or assignments as directed by the business director.

SPECIFIC UNIT/AREA RESPONSIBILITIES:
• Claims submitted to insurance carriers in a timely manner (EC2000).
• Aging balance less than 17% for visits greater than 90 days.

To apply for this job please visit www.ccswok.com.