Insurance Specialist II - Work from Home

  • Remote
  • 8 days ago


Job Description

***Xtend offers competitive benefits including Medical/Dental/Vision, Generous Paid Time Off/Paid Holidays/Monthly Bonus Eligibility/Tuition Reimbursement/401k plan plus Employer Match/Professional Development***

Xtend Healthcare, a Navient company, is nationally recognized as the industry-leading provider of comprehensive revenue cycle solutions to hospitals and health systems.

Sustaining healthcare revenue cycle improvement is our exclusive focus with experience in all 50 states and more than 30 years of dedicated health revenue cycle experience.

We are committed to delivering solutions built around the broad revenue cycle needs of our clients.

Xtend Healthcare focuses on both clinical and financial interoperability to maximize collection of net revenue.

Xtend Healthcare provides an array of solutions for our customers including full and partial revenue cycle outsourcing, third-party insurance follow-up, self-pay, coding, CDI, and consulting services.


Xtend Healthcare is looking for an Insurance Specialist II who will be 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.


1. 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.

2. 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 Prism system and displays clear understanding of claim updates, request workflow, and action step entry into the system.

Appropriately makes request 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.

3. 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.

4. 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.


High school Diploma (additional equivalent experience above the required minimum may substitute for the required level of education)

1 year experience in a healthcare account receivables environment (hospital and/or physician) (additional equivalent education above the required minimum may substitute for the required level of experience)

Excellent oral and written communication skills

Basic computer skills

Familiar with widely used patient accounting software


Account receivables experience in a hospital setting is preferred

Organization, planning and prioritizing

Communication skills

Data management

Attention to detail and accuracy


Adaptability and flexibility

Possess excellent reading and writing skills

Strong Computer skills

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

Is able to 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

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