Claims Specialist (Day Shift)

OneOncology is positioning community oncologists to drive the future of cancer care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer. Our team is bringing together leaders to the market place to help drive OneOncology’s mission and vision.

Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of community oncologists and the patients they serve.

Job Description:

The Claims Specialist works under direct supervision of the RCM Training and EDI Manager and is responsible for paper claim submissions, mail processing, scanning/importing documents including but not limited to refund letters, refund checks, and zeropays.

Responsibilities

• Prepare and mail paper claims to primary, secondary, and tertiary payers following carrier requirements.
• Obtain and sort all incoming mail forwarding correspondence to the appropriate team(s).
• Scan and email high priority correspondence to the appropriate team for a timely response.
• Prepare checks/explanation of benefits and send to the appropriate lockbox daily.
• Scan refund letters daily.
• Scan refund checks and supporting documentation as received. Attaching appropriate insurance or patient refund notification letter to the refund check and mail to the appropriate party.
• Scan and save zeropays to focus and in the Cash Posting shared drive for posting.
• Import items that have been posted and saved in the Cash Posting shared drive from the previous day’s posting.
• Various projects assigned by the Applications Training Manager and/or other Administrative Staff.
• Other duties as assigned to help drive our mission of improving the lives of everyone living with cancer.
  
  

Qualifications

• Solid understanding of medical office procedures, terminology, and insurance claim processes.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
• Strong communication and interpersonal skills.
• High level of organization with the ability to prioritize tasks and manage time effectively.
• Self-driven, adaptable, and capable of working independently.
• Experience in a medical office or billing environment preferred.
• Familiarity with paper claim filing and payer-specific submission requirements.
• Ability to meet tight deadlines and manage workload under pressure.