Insurance Specialist

3 weeks ago

Hilo, Hawaii, United States CorroHealth Full time
About CorroHealth:

At CorroHealth, our mission is to help clients achieve their financial health goals by providing scalable solutions and clinical expertise. Our team of experts works tirelessly to solve programmatic needs, enabling our clients to succeed.

Job Summary:

The Insurance Specialist is a critical role within our organization, responsible for reviewing and resolving outstanding insurance balances on hospital or physician patient accounts. This position requires flexibility, analytical skills, and a keen understanding of complex hospital systems.

Key Responsibilities:

Effectively manage assigned insurance receivables to achieve business line expectations:
  • Meet productivity standards as outlined by business line
  • Achieve a minimum of 85% work quality scoring and accuracy on all accounts worked
  • Complete timely follow-up on assigned accounts to ensure no cash loss
  • Meet monthly cash expectations as set out for assigned client receivables
  • Ensure insurance accounts are resolved within 90 days of placement
  • Demonstrate 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 document 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 make requests for documentation based on account needs and compliance guidelines
  • Ability to navigate billing system to perform basic claim billing functions
  • Clearly prepare 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, and 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, 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
Requirements:

High School or Equivalent

Experience: 1 year experience in a healthcare receivables environment.

Must Have:
  • Excellent oral and written communication skills
  • Basic computer skills
  • Familiar with widely used patient accounting software
Other Helpful Education or Experience:
  • Organization, planning, and prioritizing
  • Communication skills
  • Data management
  • Attention to detail and accuracy
  • Problem-solving
  • Adaptability and flexibility
Knowledge, Skills, and Abilities:
  • Possess excellent reading and writing skills
  • Strong computer skills
  • Communicate successfully with patients, hospitals, insurance companies, and CorroHealth employees
  • Work individually and as part of a team
  • Possess ability to concentrate for long periods of time
  • Proficient in numeracy skills
  • Pays close attention to detail
  • Must possess excellent grammar and spelling skills
  • Proficient in knowledge and use of email and internet
  • Possess 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 are 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.

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