Insurance Agency Professional

About Us 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 seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.

The Insurance Specialist is responsible for review and resolution of outstanding insurance balances on Hospital Billing (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 guidelines.

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

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

Perform account research and route accounts through appropriate client workflows

Ability to understand, navigate and perform research of account within client host systems

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

4+ years of Epic experience

High School Diploma

Basic computer skills

Familiarity with widely used patient accounting software

Data management skills, attention to detail and accuracy

Ability to communicate successfully with patients, hospitals, insurance companies and Xtend Employees

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. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Fundamental operations of the revenue cycle are supported through our expert teams while we recast the role of clinicians through automation. This shift to a true clinical revenue cycle helps us achieve our core purpose – exceed client financial health goals. Our platforms focus on capture and application of clinical documentation while easing the burden on physicians. Scalability is prioritized in the support of client program operations. As with most revenue cycle partners, our skilled and enthusiastic team is available to outsource any portion of the cycle.