The Mid Atlantic Regional Business office supporting The US Oncology Network, located in Norfolk, VA is looking for an experienced Insurance Specialist with In Office Dispensing or Retail Pharmacy billing experience to join our team. The US Oncology Network is one of the nation's largest networks of community-based oncology physicians dedicated to advancing cancer care in America. The US Oncology Network is supported by McKesson Specialty Health, a division of McKesson Corporation focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology and quality of care. For more information, visit www.usoncology.com.
Essential Duties and Responsibilities:
* Enters all charges into the Practice Management Systems from Enterprise Rx for both In Office Dispensing and Retail Pharmacy transactions for practices serviced by the RBO. * Reviews reports, identifies denied claims, researches and resolves issues, may perform a detailed reconciliation of accounts, resubmits claim to payer (both primary and secondary). * Reviews payment postings for accuracy and to ensure account balances are current. Works with co-workers to resolve payment and billing errors. * Collaborates with site Pharmacy teams to develop/maintain SOP's regarding billing processes. * Recommends accounts for collection or write-off. * Contacts third party payers to resolve payer issues, expedite claim processing, and maximize Pharmacy claim reimbursement. * Other duties as requested or assigned.
* Minimum two (2) years pharmacy claim resolution with payers. * Proficiency with computer systems and Microsoft Office (Word and Excel) required. Operational knowledge of Enterprise Rx a plus. * Demonstrated knowledge of state, federal, and third party pharmacy claims processing required. * High school graduate or equivalent required. Associates degree in Finance, Business or pharmacy technician certification preferred
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 may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work is performed in an office environment. Involves frequent interaction with staff, physicians' patients and outside insurers.
The US Oncology Network is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.