About the role
About Us:
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.
JOB SUMMARY:
This position is 100% REMOTE. Must reside in the United States
The Insurance Specialist is responsible for review and resolution of outstanding insurance balances on hospital-based (HB) patient accounts. The Insurance Specialist will be required to have extensive experience using Epic, hospital systems, and keen analytical skills to evaluate appropriate next steps to bring aged account receivables to resolution. The Insurance Specialist will be responsible to ensure cash recovery goals are met and assigned hospital receivables are appropriately addressed according to company, client and federal guidelinesESSENTIAL DUTIES AND RESPONSIBILITIES:
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.
This position is 100% REMOTE. Must reside in the United States
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.
Effectively manages assigned insurance receivables to achieve business line expectations
Meets productivity standards as outlined by business line
Maintains quality and accuracy on all accounts worked
Completes timely follow-up on assigned accounts to ensure no cash loss
Meets monthly cash expectations as set out for assigned client receivables
Ensures insurance accounts are resolved within defined SLA
Demonstrates the ability to prioritize work with some oversight to meet outlined goals
Perform account research and route accounts through appropriate client workflows
Ability to understand, navigate and perform research of account within client host systems
Exceptional understanding of patient accounting systems allowing for ease of transition and learning of new systems as needed by business line
Clearly documents actions taken and next steps for account resolution in patient accounting system
Excellent working knowledge of Epic & Prism systems and displays clear understanding of claim updates, request workflow, and action step entry into the system
Appropriately makes requests for documentation based on account needs and compliance guidelines
Ability to navigate billing system to perform basic claim billing functions
Clearly prepares appeals for payment to insurance company when appropriate
Ensure strong communication skills to convey intricate account information
Ensure all accounts are worked within client standards and Federal Regulations
Maintain high quality account handling per client standards
Work within federal, state regulations, department/division & all Compliance Policies
Maintain clear, concise, and accurate documentation of all attempts and/or contacts made and received for accounts in accordance with company and client specifications
Maintain continuing education, training in industry career development
Maintain current knowledge of and comply with all federal and state rules and regulations governing phone calls and collections including HIPAA, Privacy Act, FCRA, etc.
Attends training sessions as directed by management
Integrate information obtained through training sessions and policy changes immediately into daily routine
MINIMUM QUALIFICATIONS & REQUIREMENTS:
4+ years of experience in a healthcare receivables environment, primarily HB
4+ years of Epic experience
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
Ability 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
PHYSICAL DEMANDS:
Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.
Originally posted on Himalayas