Insurance Specialist II

4 weeks ago

Remote, United States Xtend Healthcare, LLC Full time
***Xtend offers competitive benefits including Medical/Dental/Vision, Generous Paid Time Off/Paid Holidays/ Tuition Reimbursement/401k plan plus Employer Match/Professional Development***

Xtend Healthcare, a Navient company, is nationally recognized as the industry-leading provider of comprehensive revenue cycle solutions to hospitals and health systems. Sustaining healthcare revenue cycle improvement is our exclusive focus with experience in all 50 states and more than 30 years of dedicated health revenue cycle experience. We are committed to delivering solutions built around the broad revenue cycle needs of our clients.

Xtend Healthcare focuses on both clinical and financial interoperability to maximize collection of net revenue. Xtend Healthcare provides an array of solutions for our customers including full and partial revenue cycle outsourcing, third-party insurance follow-up, self-pay, coding, CDI, and consulting services.

THIS POSITION WILL BE REMOTE. CANDIDATE MUST PERFORM WORK IN THE US.

Xtend Healthcare is looking for an Insurance Specialist II who will be responsible for review and resolution of outstanding insurance balances on hospital or physician patient accounts. The Insurance Specialist will be required to have flexibility to learning and comprehending complex 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 guidelines.

JOB SUMMARY:

1.  Effectively manages assigned insurance receivables to achieve business line expectations.

·         Meets 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.

·         Meets 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.

2.  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 Prism system and displays clear understanding of claim updates, request workflow, and action step entry into the system.

·         Appropriately makes request 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.

3.  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.

4.  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, FDCPA, Privacy Act, FCRA, etc.

·         Attend training sessions as directed by management.

·         Integrate information obtained through training sessions and policy changes immediately into daily routine.

MINIMUM REQUIREMENTS:

·         High school diploma (additional equivalent experience above the required minimum may substitute for the required level of education)

·         1 year of accounts receivables healthcare billing experience (additional equivalent healthcare education above the required minimum may substitute for the required level of experience)

·         Excellent oral and written communication skills

·         Basic computer skills

·         Familiar with widely used patient accounting software

PREFERRED QUALIFICATIONS:

·         Hospital billing experience

·         Organization, planning and prioritizing

·         Communication skills

·         Data management

·         Attention to detail and accuracy

·         Problem-solving

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