Insurance Benefits Coordinator

Summary

Coordinates with all Red Rock sites to determine, verify and establish payer sources. Sets up All Funding Sources in the computer system, enrolls new/existing consumers in DMH eligibility as needed, verifies insurance eligibility/coverage, verifies insurance for upcoming appointments, maintains all insured financial information and assists with funding and financial related calls.

Essential Functions and Responsibilities

• Responsible for the verification of insurance for all Red Rock consumers
• Daily Appointment Schedule
• OHCA TPL reporting
• Weekly PICIS reports
• Follow-up on Missing or Incomplete Consumer Information
• Daily Default Monitoring
• Establishes all funding sources for each Red Rock site and enters all required data into the computer while maintaining a high level of accuracy, professionalism and integrity
• Documents an appropriate level of detail to maintain an accurate account of eligibility history
• Coordinates with payers including, but not limited to: Medicaid, contractors, commercial insurance companies, etc. by phone, fax, email or online portal, to obtain insurance benefits and eligibility information
• Communicates all necessary information to each Red Rock site as needed including insurance terminations, etc.
• Identifies consumer responsibility to include any co-pay, co-insurance and outstanding deductible and notes the account accordingly
• Maintains knowledge of Red Rock’s financial procedures and adheres to all financial guidelines.
• Assists in educating staff in each Red Rock site regarding funding needs/changes
• Attends staff meetings, workshops, and seminars to learn agency policies, rules, regulations, and procedures; participates in ongoing in-service training as well as pertinent external training
• Performs other duties as required

Qualifications

• One year of related healthcare experience and/or training; or equivalent combination of education and experience
• High school diploma or equivalent
• Equivalent combinations of education and experience
• Ten key, computer/data entry, spreadsheets, and word processing
• Ability to work independently, with diligence and accuracy
• Analytical and problem-solving skills
• Detail oriented, with excellent organizational skills
• Excellent verbal and written communication skills
• Commitment to the mission of Red Rock BHS
• Preferred one year of related experience

Physical Requirements

• Must have the ability to stand or sit for long periods of time
• Must have the ability to lift, push, or pull a minimum of 25 pounds
• Ability to travel approximately 10% of the time
• Ability to use telephone, PC, fax machine, copy machine, and printer