Description

We are looking for you! Do you want to be a part of the team that transforms lives? Cumberland Heights is more than a campus on 177 acres, it’s a community. Our mission is providing the highest quality care possible for persons and families who are at risk for or who are suffering from the disease of chemical dependency. Treatment encompasses the physical, mental, emotional, and spiritual dimensions of recovery by offering a safe, loving and healing environment, combining professional excellence and the principles of the Twelve Steps.

Cumberland Heights Foundation offers a comprehensive benefits program, which includes:

· Medical, Dental and Vision effective 1st day of month following 28 days of employment

· Employer Contribution for Health Saving Account or Health Reimbursement Account

· 401K with Company match and eligibility after 90 days of employment

· Paid Time Off (PTO) accrual beginning day (1) one and up to 20 days of PTO the first year 

POSITION SUMMARY

The Insurance Collections Specialist is responsible for obtaining maximum insurance reimbursement of the post-discharge patient accounts. This position deals directly with third party payers and patients collecting insurance payments primarily by phone but may also utilize electronic transmissions as well as web based processes. The position also converts accounts receivable to cash, verifies accurate insurance payments based on contracted rates, and resolves disputes in a timely manner.

PRIMARY DUTIES AND RESPONSIBILITIES include some or all of the following:

1. Performs day-to-day operations associated with collection procedures and follow up.
2. Communicates with patients and guarantors with questions or concerns about accounts, statements, and information required from third party payers to process post discharge claims for payment.
3. Monitors appeals and retroactive authorization requests created by utilization review.
4. Audits explanation of benefits (EOB) to ensure accurate payments and contacts insurance payors if not paid in accordance with contract terms.
5. Collaborates with supervisor to review problem accounts and contract disputes.
6. Post payments, charges and adjustments according to policy and procedures on a daily basis.
7. Generates collection letters to patients regarding account status.
8. Utilizes an electronic worklist to resolve claims in a timely fashion.
9. Communicates daily with third party payers to ensure prompt and accurate insurance reimbursement.
10. Audits and notes payments and co-pays in patient accounting systems.
11. Submits claims electronically or manually.
12. Acts as backup to other Accounts Receivable staff.
13. Ensures that a welcoming, safe and healing environment is maintained for each patient and family throughout the continuum of care.
14. Recommends ways to improve the quality and delivery of services.
15. Ensures proper handling and distribution of company funds.
16. Maintains confidentiality of company and patient information.
17. Reacts productively to change.
18. Performs other duties as assigned.

SUPERVISORY RESPONSIBILITIES

None

Requirements

• High school diploma or GED is required.
• Two (2) years collections or other Accounts Receivable experience required.
• Intermediate computer skills including Microsoft Office Suite (Outlook, Work and Excel)
• Experience with AS400 and medical software preferred.
• Ability to problem-solve, analyze, and interpret information.
• Excellent customer service skills and attention to detail.
• Ability to remain calm and supportive when dealing with hostile persons via phone.
• Excellent written and oral communication skills with the ability to effectively speak, read and write in English.
• Ability to interact with co-workers in a collaborative and courteous manner while providing guidance, instruction, and training.
• If recovering, one year of verifiable abstinence required with two years preferred; active participation in a twelve-step program preferred.

WORK ENVIRONMENT

• Position is in an office setting that involves everyday risks or discomforts requiring normal safety precautions. 
• Position requires frequent contact with people in crisis, including those who are emotionally volatile and may require additional safety precautions.
• Ability to lift up to 20 lbs. and move around campus on uneven and rural terrain.
• Ability to speak, hear, see, sit, walk, stand, reach, and use fine/gross motor skills.