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Performs daily routine monitoring of schedule for accuracy. Utilizes the electronic health record system to acquire all documentation and authorization prior to rendering of service. Communicates with insurance companies to acquire verification of benefits/eligibility. Reports any discrepancies to the appropriate personnel in a timely manner. Works collaboratively with reception and billing department staff to assist in the completion of daily requirements in the finance department. Works collaborative with Reception staff /Care Coordinators/Case Managers to facilitate assistance with client financial burden.
Essential Job Functions
1. Communicate directly with insurance companies on a daily bases to acquire patient authorization for all recommended services prior to rendering of service.
2. Ensure accurate client insurance/authorization information and attach all supportive documentation into the patient dashboard in the EHR system. Verify and update insurance information as warranted. (must enter all authorization within the EHR)
3. Report to department lead any non-billable services due to authorization not acquired within a timely manner. All loss of revenue must be report with supportive documentation to department lead.
4. Work side by side with Registration Specialist to ensure the decrease of loss revenue due to authorization.
5. Obtain all Managed Care organization authorization on a daily basis, prior to rendering of service(s). Includes Non-par request.
6. Work directly with all clinical staff to acquire all clinical information needed to request insurance authorization.
7. Email all information to the proper provider and/or staff member of any changes in insurance coverage and update profile on our EHR system.
8. Work collaborative with Care Coordinator and/or Case Manager to assist client with seeking financial assistance as needed. Process includes but is not limited to, seeking county funding. (i.e. SAM, COCA, BCYS, etc.).
9. Monitor client schedule for accuracy, authorizations, and verification of benefits.
10. Maintain a high level of customer service and professionalism both in dealing with the public and within the organization.
11. Retrieve information from practice management system in order to acquire and complete all authorization prior to rendering of service, on the same day as necessary.
12. Create 270/271 files to upload and download from the electronic health reports to clearing house for all payers.
13. Assist with client check in process, as needed.
14. Properly navigate received telephone calls to the appropriate staff member.
15. Develop an understanding of trauma and how it impacts others.
16. Incorporate trauma informed practices into job duties and responsibilities, including interactions and communications with others.
17. Be an active member of BCC’s culture of caring through positive and engaging social interactions.
18. Perform all other related duties and responsibilities as assigned.
* High school diploma
* Plus three (3) years of office experience.
* Flexibility with hours, including evenings required.
* Excellent communication skills required.
* Excellent attention to detail required.
* Bilingual ability in English and Spanish preferred.
* Knowledge of or experience with trauma-informed approaches preferred.
To perform this position successfully, an individual must be able to perform each essential function satisfactorily. The requirements are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made.
All offers of employment are contingent upon the following: 1) Receipt of results of a satisfactory drug and alcohol screening test. 2) Receipt of the originals of the following background checks: PA State Police Criminal History, PA State Child Abuse, and DPW FBI Criminal History. These clearances must be valid within the 12 months prior to employment. A conviction is not a bar to employment, however a review will be conducted to make a determination of employment should a conviction be present. 3) Receipt of original documentation and verification of relevant degrees, diplomas, certificates, or licensure. 4) Confirmation that you are not on the OIG Federal Healthcare Program Exclusion from Participation list. Should you appear on this list, Berks Counseling Center is prohibited from employing you.