Insurance Eligibility Verification Specialist

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Pinnacle Treatment Centers, Inc.

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1001 - 5000 Mitarbeiter

Gegründet 2006

🧘 Wellness

👥 B2C

🌍 Soziale Wirkung

Wellness • B2C • Social Impact

Pinnacle Treatment Centers, Inc. betreibt ein landesweites Netzwerk von Suchtbehandlungszentren, die stationäre, ambulante, Entgiftungs-, medikamentengestützte Behandlungen (MAT) und Verhaltenstherapien anbieten. Die Organisation bietet evidenzbasierte Programme für Substanzgebrauchsstörungen (einschließlich Opioiden, Alkohol, Meth, Fentanyl, Stimulanzien, verschreibungspflichtige Medikamente) und zugleich auftretende psychische Gesundheitsprobleme, mit Dienstleistungen wie Einzel-, Gruppen- und Familientherapie, Traumabetreuung, Achtsamkeit und ergänzenden Therapien. Pinnacle legt Wert auf Zugänglichkeit (über 135 Standorte), Akkreditierung durch CARF, AATOD, NABH und RCPA, Versicherungsannahme einschließlich Medicaid und Medicare OTPs sowie 24/7-Aufnahmeunterstützung, um Patienten einen schnellen Start in die Genesung zu ermöglichen.

Beschreibung

• Responsible for verifying patients’ insurances, as well as their covered benefits and for confirming pre-authorizations for services. • Works well as part of a team and effectively communicates. • Assists practice staff with eligibility, as necessary. • Serves as a liaison between the RCM department and the various PTC facilities. • Handle high volume of inbound/outbound calls for patients that need to be screened financially and medically for financial assistance. • Complete verification of benefits for multiple clients within the appropriate timelines. • Maintains high quality customer service standards in compliance with federal and state regulations and guidelines. • Provide periodic processing status updates. • Assist in researching reimbursement issues relevant to benefits/eligibility issues. • Assist in training of new team members. • Enter and update patient demographics into the billing system as needed. • Complete KPI reports as requested by management and the clients. • Update and manage the VOB tracker for multiple clients. • Understand federal and state requirements regarding client confidentiality and the principles of maintaining protected health information (PHI). • Work effectively and maintain expected productivity. • Other tasks or duties as assigned.

🎯 Anforderungen

• Associate’s degree preferred or experience in lieu of degree. • 1-2 years'+ experience in front-end medical office operations. • Prior experience working in a role with a high volume of either inbound or outbound calls. • Experience and knowledge of federal or state government agencies including Social Security, Medicaid and/or Commercial coverages, familiar with the healthcare revenue cycle touching patient accounts. • Experience working in a role that requires prioritization of multiple critical priorities while ensuring quality and achievements of performance metrics. • Experience with customer interactions which requires live, accurate documentation of the encounter. • Previous experience collecting patient payments or copays.

🏖️ Vorteile

• 18 days PTO (Paid Time Off) + 8 paid holidays • 401k with company match • Company sponsored ongoing training and certification opportunities. • Full comprehensive benefits package including medical, dental, vision, short term disability, long term disability and accident insurance. • Substance Use Disorder Treatment and Recovery Loan Repayment Program (STAR LRP) • Discounted tuition and scholarships through Capella University