Insurance Specialist

About the role

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.

Responsibilities

• Effectively manages assigned insurance receivables to achieve business line expectations
• Mets productivity standards as outlined by business line
• Achieves a minimum of 85% work quality scoring and accuracy on all accounts worked
• Completes timely follow-up on assigned accounts to ensure no cash loss
• Mets monthly cash expectations as set out for assigned client receivables
• Ensures insurance accounts are resolved within 90 days of placement
• Demonstrates the ability to prioritize work with some oversight to meet outlined goals
• Performs account research and routes accounts through appropriate client workflows
• Understands, navigates and performs research of account within client host systems
• Clearly documents actions taken and next steps for account resolution in patient accounting system
• Applies excellent working knowledge of Prism system and displays clear understanding of claim updates, request workflow, and action step entry into the system
• Applies appropriate requests for documentation based on account needs and compliance guidelines
• Performs basic claim billing functions within the billing system
• Prepares appeals for payment to insurance company when appropriate
• Ensures strong communication skills to convey intricate account information
• Ensures all accounts are worked within client standards and Federal Regulations
• Maintains high quality account handling per client standards
• Works within federal, state regulations, department/division & all Compliance Policies
• Maintains clear, concise, and accurate documentation of all attempts and/or contacts made and received for accounts in accordance with company and client specifications
• Maintains continuing education, training in industry career development
• Maintains current knowledge of and complies with all federal and state rules and regulations governing phone calls and collections including HIPAA, FDCPA, Privacy Act, FCRA, etc.
• Attends training sessions as directed by management
• Integrates information obtained through training sessions and policy changes immediately into daily routine

Qualifications

• 1 year of experience in a health care receivables environment
• High School Diploma
• Excellent oral and written communication skills, basic computer skills, familiarity with widely used patient accounting software
• Data management skills, attention to detail and accuracy, good problem-solving skills
• Able to communicate successfully with patients, hospitals, insurance companies and Xtend Employees
• Able to work individually and as part of a team
• Possess ability to concentrate for long periods of time
• Proficient in numeracy skills and above average knowledge of administrative procedures