Insurance Verification Specialist
3 weeks ago
Description
- I) Job Purpose
Responsible for a variety of tasks to support the function of Administration. Responsible for Data Entry in local and state data bases. Shared responsibility for maintaining and reconciling internal and external information and reports in local and state data bases. This position requires me to use my education and training to make decisions.
II) Essential Functions
A) Verify client insurance benefits and enter information in Local and State Databases, as assigned.
B) Fax insurance authorizations and request for records, as applicable.
C) Verify and enter Family Cost Share in Local and State Databases, no permission to bill, and no insurance, as required.
D) Complete Family Cost Share Billing Spreadsheet by researching EOBs to obtain clients final financial responsibility, as applicable.
E) Review and reconcile data and reports as required.
F) Performance standards are performed as applicable with MHMR's We CARE values "We Connect People in Our Community. We Provide Access to Services. We Link People to Resources. We Empower People."
G) Performs other job duties or responsibilities as requested or assigned.
III) Knowledge of Laws, Regulations, Policies/Procedures, Skills, and Abilities
A) My Avatar Operating Procedures
B) ECI Policy and Procedures
C) EPSDT/CCP
D) Medicaid Administrative Claiming/Targeted Case Management
E) Medicaid Policy and Procedures
F) MHMRTC Operating Procedures
G) Ability to demonstrate flexibility with work, attitude, and communication with ECI staff and families.
H) Ability to demonstrate emotional control, good judgment, and safe practices when under stress.
I) Ability to demonstrate ethical and professional behavior.
J) Ability to independently plan and organize work.
K) Above average record keeping, time management and organizational skills.
L) Ability to understand and implement complex written and verbal instructions.
M) Knowledge of services provided by ECI.
N) Ability to strive to make effective working relationships with ECI staff, team members and families that are characterized by mutual support, open communication, trust, and respect.
O) Ability to problem solve with infrequent assistance from supervisor. Identify and use a rational approach for the situation.
P) Communicate problems and decisions to the supervisor.
Q) Ability to discuss uncomfortable and potentially conflict producing topics, in a professional and effective manner, with families, community agencies and other ECI staff.
R) Basic computer skills, with 9,000 keystrokes per hour, and 40 words typed per minutes.
IV) Internal & External Customer Service
A) This position requires extensive internal (team members, agency personnel) and external contacts. The position will accomplish this with above average written and oral skills.
V) Travel
A) Adhere to MHMR Mileage and Travel reimbursement policy and any other aspect regarding travel.
B) This position requires minimal local travel in personal vehicle.
C) This position may require travel to agency program sites.
VI) Equipment Used
A) Utilized as required for position.
- VII) Minimum Qualifications
A) Minimum Education: High School Diploma/GED
B) Defined Education: None
C) Preferences: Bilingual preferred but not required
D) Substitutions: None
E) Years' Experience: Three (3) years
F) Defined Experience: Billing and/or related accounting field
G) License/Certifications: Valid Texas Driver's License
H) Special Courses: None
I) Supervisory Experience: None
VIII) Agency Requirements
A) All staff are required to participate in agency Emergency Preparedness and Environmental Safety programs and may be assigned by their department as a key/essential staff level function during critical events or for the purpose of sustaining business continuity.
B) This position may require temporary or permanent re-assignment to any MHMR Tarrant facility as determined by program needs and/or the Division/Director.
C) Assigned work hours may change as the needs of the agency change.
D) The Functional Title of this position may change as the needs of the agency change.
E) All work will be completed within the scheduled work hours. All non-exempt (hourly) employees are expected to clock in and clock out for each work shift, no work should be done off the clock.
F) MHMR reserves the right to change, add to or eliminate positions as it deems appropriate.
G) Employment is at will, as well as agency needs may change.
H) Agency dress code is to be followed at all times.
I) Physical on-site presence, including regular attendance and punctuality, is an essential function of this position. Any changes or adjustments to your assigned work schedule or shift hours must be approved by your supervisor in advance.
Lifting requirements 15-25#
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