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Insurance Claims Analyst
2 months ago
About Xtend Healthcare
Xtend Healthcare specializes in revenue cycle management tailored specifically for the healthcare sector. Our offerings encompass complete revenue cycle outsourcing, accounts receivable legacy cleanup, extended business office services, as well as coding and consulting projects. As a subsidiary of Navient (Nasdaq: NAVI), Xtend leverages the robust capabilities of a large-scale business processing solutions provider. Discover more about us at
THIS POSITION REQUIRES ONSITE PRESENCE.
Work Schedule: Monday to Friday; 8 am to 4:30 pm.
Xtend Healthcare is in search of an Insurance Claims Analyst who will be tasked with reviewing and resolving outstanding insurance balances related to hospital or physician patient accounts. The Analyst will need to demonstrate adaptability in learning and understanding complex hospital systems, along with strong analytical skills to assess appropriate actions for resolving aged account receivables.
The Analyst will be accountable for ensuring cash recovery targets are achieved and that assigned hospital receivables are managed in accordance with company, client, and federal regulations.
JOB SUMMARY:
1. Efficiently manages assigned insurance receivables to meet business line expectations.
- Adheres to productivity benchmarks as established by the business line.
- Achieves a minimum of 85% accuracy and quality scoring on all accounts processed.
- Conducts timely follow-ups on assigned accounts to prevent cash loss.
- Meets monthly cash recovery targets as defined for assigned client receivables.
- Ensures resolution of insurance accounts within 90 days of assignment.
- Exhibits the ability to prioritize tasks with some oversight to meet established objectives.
- Possesses the ability to understand and perform research within client host systems.
- Demonstrates a strong understanding of patient accounting systems, facilitating a smooth transition and learning of new systems as required by the business line.
- Accurately documents actions taken and next steps for account resolution in the patient accounting system.
- Exhibits excellent knowledge of the Prism system, demonstrating a clear understanding of claim updates, request workflows, and action step entries.
- Requests necessary documentation based on account requirements and compliance standards.
- Navigates billing systems to execute basic claim billing functions.
- Prepares appeals for payment to insurance companies when warranted.
- Maintains strong communication skills to relay complex account information effectively.
- Maintains high-quality account handling in line with client standards.
- Operates within federal and state regulations, as well as department/division and all compliance policies.
- Keeps clear, concise, and accurate documentation of all attempts and/or contacts made for accounts in accordance with company and client specifications.
- Stays informed of and complies with all federal and state regulations governing communications and collections, including HIPAA, FDCPA, Privacy Act, FCRA, etc.
- Participates in training sessions as directed by management.
- Integrates information gained from training sessions and policy updates into daily operations promptly.
- High school diploma (additional equivalent experience may substitute for the required level of education).
- 1 year of experience in hospital accounts receivable and billing (additional equivalent education may substitute for the required level of experience).
- Strong oral and written communication skills.
- Strong organizational, planning, and prioritization skills.
- Effective communication abilities.
- Proficient data management skills.
- Attention to detail and accuracy.
- Problem-solving capabilities.
- Adaptability and flexibility.
- Excellent reading and writing proficiency.
- Strong computer skills.
Navient is an equal opportunity employer, committed to diversity and inclusion. All employment decisions are made without regard to race, ethnicity, sex, disability, protected veteran status, sexual orientation, or gender identity. Navient Corporation and its subsidiaries are not sponsored by or agencies of the United States of America.
Navient maintains a drug-free workplace.
