ESSENTIAL DUTIES AND RESPONSIBILITIES includes the following:

Reports to work when scheduled and on time.

Prior Authorization & Third Party Responsibilities: 

• Verify insurance benefits and enter the correct payer source upon verification. 
• Request initial prior authorizations for third party payers, primarily Medicaid and MCO’S as needed. 
• Requests CSA documentation from clinical staff and request prior authorizations for continued stay requests for Medicaid/MCO. 
• Communicate with clinical staff when treatment plan errors are found in regards to coding & program placement. 
• Update denial detail log in a timely manner. 
• Assist the PA Coordinator with sending off discharge information to payers and tracking patients change in level of care to ensure a prior authorization is obtained. 
• Run/monitor crisis report to request authorizations. 
• Consistently and efficiently, verify Medicaid eligibility to monitor change in coverage and notify designated counselor for clinical documentation.
• Enter services accurately and timely into the patient system.

Auditing:

• Run/monitor program admission reports to ensure payers are being entered accurately.
• Audit consents, other EHR forms, and activities entered staff primarily, Withdrawal Management staff. 

Admission and Customer Service Responsibilities: 

• Provide exceptional customer service.
• Greet incoming patients, verify identity, and accurately enter information required including demographics, payment source and other intake information required for admission into the Electronic Healthcare Records system.
• Explain legal consents, program forms, and other intake information during the point of entry process while obtaining necessary signatures.
• Schedule patients for initial appointment in patient system.
• Answer patient questions regarding the admission process or refer to appropriate program staff to assist.
• Collect and post payments to the patient system.
• Assist patients with questions and concerns regarding their account after thoroughly researching their account.

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Minimum Education and/or Experience

A high school diploma or GED is required; an Associate’s degree (A.A.) or equivalent from a two-year college or technical school is required. Ability to generate, interpret and work system reports is required. Six months to one year related experience and/or training are also required; or equivalent combination of education and experience.

Third party billing experience is required.

Please complete the online application to include all current and previous employment history and education. A resume cannot be substituted for completing the employment history and educational fields of the employment application. Incomplete applications will not be considered.

**LRADAC maintains a tobacco-free environment. No smoking or use of any tobacco product is permitted in any of its facilities or on any of its properties.**