保险专员
Insurance Specialist
关于我们：
我们的目标是帮助客户实现其财务健康目标。在整个报销流程中，我们的可扩展解决方案和临床专业知识帮助解决程序性需求。通过领先的技术赋能我们的团队，使分析能够指导我们的解决方案，并确保我们达成目标。
我们通过投资于你来打造长期的职业生涯。我们希望创造一个促进你职业发展和个人成长的环境，因为我们相信你的成功就是我们的成功。
职位概述：
此职位为100%远程办公。必须居住在美国
保险专员负责审查和解决医院类（HB）患者账户上的未结保险余额。保险专员需要有使用Epic、医院系统以及敏锐的分析能力，以评估将逾期应收账款解决的适当下一步措施。保险专员需确保实现现金回收目标，并根据公司、客户和联邦指南，妥善处理分配的医院应收账款。
主要职责和责任：
注意：以下关键职责和责任旨在描述该职位的一般职责和责任，并非对该职位职责的详尽陈述。该职位可能执行以下大部分或全部主要职责。具体任务、责任或能力可能在团队成员的绩效目标中进行记录，如由团队成员的直接领导团队所规定。
此职位为100%远程办公。必须居住在美国
注意：以下关键职责和责任旨在描述该职位的一般职责和责任，并非对该职位职责的详尽陈述。该职位可能执行以下大部分或全部主要职责。具体任务、责任或能力可能在团队成员的绩效目标中进行记录，如由团队成员的直接领导团队所规定。
- 有效管理分配的保险应收账款，以达到业务线的期望
- 按照业务线的规定满足生产率标准
- 保持所有处理账户的质量和准确性
- 及时跟进分配的账户，确保没有现金损失
- 达到为分配的客户应收账款设定的月度现金期望
查看英文原文
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 build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.
JOB SUMMARY:
This position is 100% REMOTE. Must reside in the United States
The Insurance Specialist is responsible for review and resolution of outstanding insurance balances on hospital-based (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 guidelinesESSENTIAL DUTIES AND RESPONSIBILITIES:
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. 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.
This position is 100% REMOTE. Must reside in the United States
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. 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
- Meets productivity standards as outlined by business line
- 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
- Demonstrates 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 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
MINIMUM QUALIFICATIONS & REQUIREMENTS:
- 4+ years of experience in a healthcare receivables environment, primarily HB
- 4+ years of Epic experience
- 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:
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. 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.
A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.
Originally posted on Himalayas