Lead Insurance Services Rep

Overview

Lead Insurance Services Representative

Pay: $23.00 - 25.00 per hour

The Lead 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 highly skilled billing specialist who can independently coordinate and manage all phases of medical billing for mental health services while supporting the team as a subject matter expert.

The main responsibilities for this role include invoicing, claims submission, denial management and accounts receivable management. The Lead Insurance Services Specialist will serve as a primary support to the Insurance Services Supervisor as related to mentoring and developing the team, lending assistance with special projects, and taking on specific assignments as needed to support the Insurance Services team. This individual will be required to interface with operational managers, operational staff, insurance companies, utilization review teams, and families.

Responsibilities

• Support Insurance Services Supervisor with providing oversight for the Insurance Services department.

• Support Insurance Services Supervisor with hosting and participating in regular billing meetings and provide feedback for problem solving with insurance billing and A/R issues.

• Serve as the primary mentor for new hires and support the onboarding process to ensure new hires are able to work independently upon completion of training.

• Take on, or lend assistance with, special projects related to Insurance Services and the RCM team.

• Actively participate in workloads to remain a subject matter expert in all things related to the department.

• Ensures the validity and integrity of all patient insurance records.

• Responsible for timely responses to insurance rejections and denials, monitoring for trends, and providing feedback on operational processes.

• Responsible for working aging report while maintaining account status records and collection efforts in centralized note system. This includes making recommendations on adjustments, refunds, and outside collection activity in alignment with company policy and procedures.

• 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.

• Responsible for timely response on requests for refunds as received from insurance company; requests will be validated for accuracy and challenged when not accurate. This includes monitoring assigned accounts to identify overdue payments and issue refunds on overpayments.

Qualifications

• A minimum of 3-5 years prior work experience in medical billing and accounts receivable, preferable in a medical or behavioral-healthcare environment.

• Experience with electronic claims filing.

• Strong interpersonal organizational, evaluative and time management skills.

• Knowledge of state and federal regulations governing insurance billing and reimbursement.

• Working knowledge of Windows-based applications, including Outlook, Word and Excel

• 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 as evidenced by the ability to prepare, present, and review oral and written information and detailed reports.

• Exceptional organizational skills and attention to detail

• High School/GED required, Associate degree preferred

Benefits

• Comprehensive Benefit Program that includes medical insurance with a generous company contribution towards a high deductible plan, dental insurance, vision insurance, voluntary life and AD&D insurance, long-term disability, 401K with company matching, and paid maternal leave.

• Company Paid Holidays plus a PTO accrual schedule.

Embark is an Equal Employment Opportunity Employer. Embark is committed to enriching the therapeutic and healing experience it offers through the diversity of its employees and community. Embark seeks to recruit and support a broadly diverse staff who will contribute to the organization's excellence, diversity of viewpoints and experiences, and relevance in a global society. LGBTQ+ and BIPOC are encouraged to apply.