Status: Full-time position
Location: Denver, CO
Job Summary: Responsible for verifying and updating client insurance benefit information, tracking required client financial documentation, obtaining and tracking authorizations, meeting with clients to obtain information and explain benefits, coordinating insurance information with clinical sites.
Qualifications: Preferred associate’s Degree in business, medical billing or related field, or equivalent experience in healthcare/medical insurance environment.
Minimum two years of healthcare financial/business office or similar third party payer claims experience.
In-depth knowledge of benefit verification, service authorization procedures, medical terminology and insurance billing codes. Familiarity with mental health terminology a plus. Ability to multi task and perform job responsibilities with a minimum of supervision and a certain degree of resourcefulness and creativity. Strong computer, customer service and communication skills. Competence in word-processing and Microsoft Excel spreadsheet application. Ability to interact with clients and staff with the use of considerable tact and judgment. Clean driving record.
Duties: 1. Obtain and maintain accurate, detailed client eligibility information in AR and client database system.
2. Verify client eligibility and benefits.
3. Track service authorization requirements and usage and obtain authorization as necessary.
4. Act as direct liaison to assigned clinical teams, communicating about client insurance information with clinic staff.
5. Communicate changes in client information to Front Desk Staff, Clinical Staff and AR Department as indicated.
6. Assist clinicians in completion of necessary administrative paperwork related to insurance.
7. Track required client financial documentation and assist clinical teams as needed in maintaining documentation in accordance with payer requirements.
8. Meet with clients to explain benefits and financial responsibility. Initially, obtain client insurance information as needed to determine ability to pay. At least annually, or as needed, meet with clients to update benefits information.
9. Monitor client account balances, contact clients as necessary to explain balances, and assist Front Office Staff in client balance collections.
10. Assist AR Department in researching claims appeals and denials.
11. Assist clinical teams with managing client benefits.
12. Perform other duties as assigned.
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