Insurance Services Specialist

Overview

Insurance Services Specialist

Pay: $20.00 - 22.00 per hour

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.

The main responsibilities for this role include invoicing, claims submission, denial management and claims receivable management. The Insurance Services Specialist will be required to interface with operational managers, operational staff, insurance companies, utilization review teams, and families.

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

Qualifications

• 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

• High School/GED required, Associate degree preferred

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).