[Hiring] Insurance Specialist @CorroHealth

Role Description

The Insurance Specialist is 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.

Essential Duties and Responsibilities

• 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.
• Performs account research and routes 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 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.
• Ensures strong communication skills to convey intricate account information.
• Ensures all accounts are worked within client standards and Federal Regulations.
• Maintains high quality account handling per client standards.
• Works within federal, state regulations, department/division & all Compliance Policies.
• Maintains clear, concise, and accurate documentation of all attempts and/or contacts made and received for accounts in accordance with company and client specifications.
• Maintains continuing education, training in industry career development.
• Maintains current knowledge of and complies with all federal and state rules and regulations governing phone calls and collections including HIPAA, FDCPA, Privacy Act, FCRA, etc.
• Attends training sessions as directed by management.
• Integrates information obtained through training sessions and policy changes immediately into daily routine.

Qualifications

• 1 year of experience in a health care receivables environment.
• 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

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.