Patient Insurance Benefit Specialist- Traditional Business Hours
Haven Behavioral Healthcare

Haven Behavioral Health believes that recovery from mental illness is an outcome we can achieve by harnessing the wisdom of service recipients and their families with the knowledge of skilled and caring professionals. We believe that everyone has intrinsic strengths that can be used to develop an individualized recovery plan. Staff serves as positive role models demonstrating professional and caring attitudes and behaviors toward the individuals we serve, their families, co-workers, and guests. Staff contributes to effective teamwork by combining skills and energies in a coordinated effort with individuals we serve, their families, supervisors, co-workers, and outside agencies.

Who We Need

We're looking for someone with the following skills, experience and credentials: To ensure compliance & adequate services, additional job duties may be required to meet the needs of the program and or department.

POSITION SUMMARY:

Determine eligibility for insurance program participation:

• Ensures the accuracy of patient demographics and insurance information, updating as necessary
• Assist Office Assistants and Business Office in the maintenance of the EPM application for insurance management and COB coordination
• Use online web base verification systems (AHCCCs, CMS, RBHA) and reviews real time eligibility responses to ensure accuracy of insurance eligibility
• Collects, verifies and communicates necessary information with member's insurance carrier to obtain Medicaid benefit and eligibility
• Works with Management and Business Office to identify and resolve issues that threatens billing reimbursement

Initiates and assist patients with completing applications for Medicaid, Medicare SSDI:

• Screen's persons to determine eligible for Medicaid assistance and re-determines their continuing eligibility
• Responsible for accurately completing and interpreting insurance verification and benefits; notifies patient, family members, BO staff of insurance coverage issues that may result in coverage reduction
• Establish rapport and credibility with customers and providers by providing excellent customer service in a professional manner
• Performs quality checks on all eligibility/AHCCCs applications initiated and ensures they are process for all members who lose AHCCCs coverage.
• Process eligibility case files within the required timeframes established by our funding source

Facilitate eligibility screening and ongoing monitoring:

• Maintain enrollment spreadsheet for tracking and statistical purposes
• Receive electronic AHCCCs files (270/271 report) of member eligibility, review for discrepancies, and update system
• Process eligibility files into company EHR/EPM system
• Work problem list of members who lose eligibility
• Managing and updating HEA (Health-E-Arizona) report for monthly submission to MCO

• Completes miscellaneous task assigned by supervisor
• Performs administrative task such as copying, faxing, scheduling and handles internal and external telephone calls
• Adheres to HIPPA privacy and confidentiality regulations and guidelines

MINIMUM REQUIREMENTS:

Requires any combination of training, education, and experience listed below:

• Must be at least 21 years old.
• A High school diploma or high school equivalency diploma.
• Experience: Two to four years' experience in office clerical setting. Medical and/or Behavioral health experience preferred.
• Computer Skills: Proficiency in typing, using computer software, i.e., EHR/EMR systems, Word, Excel, and PowerPoint and Internet is essential.
• Required: Car, valid AZ Drivers' License, state minimum insurance coverage and ability to meet and maintain the company's acceptable driving requirements (as required per program/department requirements).

KNOWLEDGE, SKILLS, ABILITIES:

Demonstrate an understanding of current Medicaid/Medicare/Marketplace information and systems.

• Ensure the maintenance of departmental operations to achieve compliance with grant requirements, CARF accreditation, contract requirements, federal/state/local regulations and all other licensing/regulatory agencies as directed.
• Ensure that agency procedures, licensing and accreditation standards related to health and safety are maintained.
• Demonstrate superior work habits to include, but not limited to the following: time management, initiative, role modeling, leadership, organizational skills, and multitasking. Able to recognize and support the BHS department's preferences/priorities as related to the mission statement, and demonstrate commitment to ethical professional, clinical and business practices by adhering to the ACA Code of Ethics.

• Required: Car, valid AZ Driver's License, state minimum insurance coverage and ability to meet and maintain the company's acceptable driving requirements. Employment is contingent upon successfully passing an employee reference check, criminal background check, drug screening, and confirmation of qualifications.
• Computer Skills: Proficiency in typing, using computer software, i.e. Word, Excel, and Internet is essential.

As mandated by the Centers for Medicare & Medicaid Services (CMS) all employees and regular contractors of Haven Behavioral Hospital of Phoenix are required to obtain the COVID-19 Vaccine or receive approval for an exception prior to date of hire.

Haven Behavioral Healthcare is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse workforce.