Accounts Receivable Representative

COMPREHENSIVE HEALTHCARE • Yakima, WA

1d • $19 - $29 • Onsite

About The Position

Comprehensive Healthcare provides innovative behavioral health and integrated healthcare services to clients of all ages. We take pride in our creative and collaborative work environment and in delivering clinically excellent, trauma-informed, recovery-oriented services. The Accounts Receivable Representative maintains accounts receivable records according to funding source requirements and agency policy. Also responsible for verifying and entering computer data for insurance benefits including coordination of coverage information and authorizations with appropriate clinical sites to ensure revenue maximization.

Requirements

• High school diploma or GED
• Two years of related experience

Responsibilities

• Contributes to revenue maximization by analyzing funding source availability on an individual service (event) basis.
• Reviews and processes all adjustments to client accounts.
• Coordinates client account status and payment requirements with clinical staff and support staff.
• Reviews insurance denials to obtain correct information and reprocesses insurance billing to be resubmitted to correct payer source in a timely manner.
• Reviews private pay and responsible party statements for accuracy, adds delinquency reminders, follow-up address returns and sends undeliverable statements and delinquent accounts to collection.
• Completes and submits for payment Medicare, DVR, medical and insurance claim forms.
• Obtains complete retroactive certification coupons, identified and corrects impacted services.
• Demonstrates a working knowledge of all aspects of insurance verification criteria for eligibility and benefits information.
• Processes accounts according to procedures for collection referral and completes write off adjustments in computer system.
• Stays informed of changes in agency systems, funding source requirements and restrictions, and contract status and applicability, as such information impacts client accounts and funding.
• Verifies and updates client funding sources and accounts by contacting third party payers and responsible parties (e.g., school districts, district courts and juvenile authorities).
• Updates client accounts when clients, staff, and third party resources or account analysis provides additional information.
• Serves as the primary customer service representative to insurance companies for benefit coverage details for outpatient mental health services.
• Acts as a liaison between the insurance carriers, support staffs and accounts receivable.
• Verifies all coverage plans for mental health eligibility, benefits coverage, credentialing requirements, restrictions on services, approved number of visits and authorizations numbers by contacting insurance carriers for patient specific information.
• Enters all client coverage plan information into agency software system including plan name, subscriber name, subscriber identification number, group/plan number and any other required data elements associated with the coverage plan.
• Verifies outpatient mental health benefits, insurance billing addresses, specific authorized diagnosis and procedure codes for insurance companies.
• Coordinates and follow-ups with UR staff on any denials that include medical necessity issues, credentialing requirements, diagnosis restrictions or authorization limitation.
• Works closely with support, clinical and accounts receivable staff to provide timely, accurate information to assist with customer service and billing issues.
• Maintains a computer database of all employer specific insurance companies within our service area including name of insurance plan, group number, billing address and phone number and any other detailed information relevant to the coverage plan.

Benefits

• Competitive salaries within our communities and industry
• Healthcare coverage for employee and qualified family members
• Generous vacation, paid holiday and sick leave policies
• Access to Employee Assistance Program services
• Agency-funded retirement plan with contributions equal to 5% of compensation
• Additional retirement investment opportunities with a 50% investment match of up to 4% of compensation
• Agency-funded life and disability insurance program
• Financial incentives to further employee education

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED