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Insurance Services Specialist
2 months ago
The Insurance Services Specialist is responsible for submitting and collecting payments from insurance companies for various companies of Embark. This job opportunity is suited for a skilled insurance billing specialist who can independently coordinate and manage all phases of insurance billing for mental health services.
Responsibilities- Ensure timely and accurate verification of benefits for commercial and Medicaid insurance coverage as related to Behavioral Health coverage
- Ensures the validity and integrity of all patient insurance records
- Ensure timely and accurate processing of invoices and claims; responsible for submitting clean electronic and paper claims to insurance companies
- Responsible for investigation and correction of rejected claims from clearinghouse and/or insurance companies
- Responsible for timely responses to insurance denials, monitoring for trends, and providing feedback on operational processes
- Responsible for working A/R aging report while maintaining account status records and collection efforts in centralized note system
- Responsible for processing and responding to requests for information and records from insurance companies
- Responsible for timely response on requests for refunds as received from insurance company; requests will be validated for accuracy and challenged when not accurate
- Responsible for invoicing of patient co-pays and deductibles, private pay collections and A/R management
- Monitor assigned accounts to identify overdue payments and issue refunds on overpayments
- Make recommendations on adjustments, refunds, and outside collection activity in alignment with company policy and procedures
- Partner will utilization review team to ensure timely billing to third party payors
- Participate in regular billing coordination meetings and provide feedback for problem solving with A/R issues
- Engage in cash application process, making sure all cash receipts are applied accurately and timely
- Provide feedback to program on how to ensure compliance while maximizing revenue
- A minimum of 2 years prior work experience in medical billing and accounts receivable, preferable in a medical or behavioral-healthcare environment
- Experience with electronic claims filing
- Working knowledge of Windows-based applications, including Outlook, Word and Excel
- Hands-on experience with accounting software and familiarity with MS Excel to include strong analytical skills
- Strong and professional communication skills
- Skilled in negotiation and problem-solving aptitude
- Patience and ability to manage stress and maintain confidentiality
- Excellent written and verbal communication skills
- Exceptional organizational skills and attention to detail
Embark Behavioral Health is a unique organization comprised of extraordinary programs dedicated to bringing the current all-time high rates of adolescent anxiety, depression, and suicide to all-time lows within the decade while becoming the most recognizable, respected, and valuable behavioral health organization in the world.
Embark is a leading network of clinical and therapeutic programs (residential treatment centers, young adult transition programs, outpatient centers, addiction treatment facilities, wilderness therapy programs, support services, and more) that offer a comprehensive set of services that run the span of acuities, ages, and services. All programs offer state-of-the-art therapeutic interventions, lead the way in quality standards, deliver measurable outcomes and are all tied together via a shared set of core values (empathy, service, trust, growth, and results).