Client Benefits Specialist
CrossWinds Counseling & Wellness - emporia, KS
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Job Details Job Location Region I Lyon - Emporia, KS Position Type Full Time Education Level High School Salary Range $20.76 Hourly Description The Client Benefits Specialist is responsible for obtaining insurance pre-authorizations, assisting clients with obtaining and maintaining health insurance coverage, submitting insurance claims, and following up on accounts receivable. The Client Benefits Specialist works closely with members of the client's care team to address any barriers to maintaining maximum insurance coverage. Essential Functions Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Assists clients with the process of obtaining and maintaining maximum insurance coverage, including identifying available health care insurance options as needed. Verifies entry of payor sources in the electronic medical record (EMR). Remains current on available insurance options, including eligibility and enrollment requirements. Confirms eligibility and benefits of third-party insurers via online eligibility databases or via telephone for applicable clients prior to claims submission, especially for the Medicaid program. Responds to staff requests for confirmation of eligibility as needed for updating treatment plan and referral to other services. Obtains treatment service authorizations from insurers by receiving facsimile requests from payors, acquiring authorization information from clinical staff, and responding to requestor in a timely manner. Monitors treatment authorizations that are due to expire. Enters and maintains insurance coverage and related demographic information in the billing system. Troubleshoots service claim problems by utilizing reports within the computer billing program to ensure proper billing. Assembles batches of insurance claims for payment to third-party insurers. Submits claims electronically or prints and prepares paper health claim forms for mailing. Develops an in-depth working knowledge of the agency's financial policies and third-party billing codes and utilizes relevant information in performing job tasks and sharing knowledge with staff. Monitors the status of and works to close pending insurance claims and outstanding client balances per departmental goals. Reaches out to clients regarding unpaid account balances. Works closely with community and governmental agencies, including Social Security, Medicare, and private insurance companies to assist clients in resolving insurance problems. Answers incoming telephone calls to the insurance department in a professional and courteous manner and assists individuals with billing and statement questions. Attends staff meetings and departmental training. Work Environment This job operates in a professional office setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. This list is not exhaustive and may be supplemented as necessary. While performing the duties of this job, the employee is occasionally required to stand; walk; sit; handle objects; grasp and reach for items with hands and arms; manipulate hands and fingers; climb stairs; balance; stoop, kneel, or crouch; and talk or hear. The employee must occasionally lift or move up to 10 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. Language skills are required, including the ability to read, write, comprehend, and speak the English language. This position also requires the ability to interpret written materials, write reports and business correspondence, and effectively present and respond to questions. Position Type/Expected Hours of Work This is a full-time position. Days of work are Monday through Friday, 8:00 am to 5:00 pm. Travel Travel is not required. Qualifications Required Education and Experience High School diploma or equivalent.Prior experience in insurance billing for a behavioral health agency. Preferred Education and Experience Bachelor's Degree. Additional Eligibility Qualifications Possess competency in conducting highly-organized and detail-oriented work; demonstrated ability to work with large volumes of information is an efficient manner; ability to handle and respect confidential, sensitive information; possess demonstrated interpersonal and problem solving skills; ability to work independently and as a member of a team; possess prior computer experience in Microsoft Office programs and moderate to advanced computer fluency; previous work experience in performing insurance and healthcare billing desirable.
Created: 2024-10-02