Insurance verification​/COLLECTOR

Responsibilities

Laurel Heights Hospital located in Atlanta, Georgia has a full-time Insurance Verification/Collector position. Laurel Heights Hospital is an intensive Residential Treatment / Acute and Autism Spectrum Disorders Program for children and adolescents. We serve and treat severe and complex psychiatric and behavioral difficulties and co-occurring psychiatric issues. EOE.

• Full comprehensive benefits package offered to full-time employees including health, vision, dental, life, retirement, short‑term/long‑term disability, and supplemental insurance.
• Employee assistance program and employee perks network included.
• Full‑time hours (40/week) guaranteed!

Bachelor’s degree in business or finance preferred or equivalent experience.

Minimum of two (2) years’ experience in accounts receivable and business office functions preferred, including experience with insurance companies and a working knowledge of insurance terms, rates, policies and reimbursement procedures preferred.

Previous work in a hospital business office or utilization review experience preferred. Have the ability to deal with diverse and stress‑related situations in a calm manner.

Must be detail oriented and highly accurate.

Effective oral and written communication and guest relations skills required.

Must have good organizational and computer technical skills and have the ability to set priorities.

Prefer knowledge of psychiatric care, utilization review, insurance reimbursement procedures, DSM‑IV, etc.

Organizes and conducts business office operations in accordance with facility standards.

Implements procedures for filing reimbursement claims and follow up.

Maintains proper documentation with regard to cash receipts, revenue, census, bad debt, and contractual and administrative adjustments.

Negotiates contracts with potential funding sources as requested.

Verifies financial coverage of all patients after admission and coordinates initial financial contract if not done at the time of admission.

Prepares and distributes all reports as required by facility and corporate policy.

Serves as liaison for patients and hospital with insurance companies.

Has a working knowledge of all levels of care offered and appropriately manages patient benefits.

Participates in the patient discharge process.

Insurance Verification
:
Verify insurance benefits within a 24‑hour time frame for all admissions received during regular business hours. Weekend admissions should be verified within 72 hours. Initiate phone calls to insurance companies to determine extent of coverage (if any), certification requirements and other policy limitations, and deductible and co‑pay provisions. Communicate with the Business Office, Assessment staff, and Utilization Review any changes or benefit issues via email.

Enter benefits into TIER for all potential patients whose benefits are checked prior to the patient physically arriving at the facility. All benefits verified will be keyed into AS400.

Quality Audits
:
Review and update documentation by the Assessment counselors pertaining to patient insurance, demographics, or financial counseling notes. QA all admission information to ensure accuracy.

Financial Counseling
:
Meet with families and patients to obtain necessary payments needed for hospital programs (IP, PHP, IOP and ECT). Make financial arrangements for self‑pay obligations as approved and procure any required deposits. Meet with patients who are potentially going to attend another level of care to ensure payments are made and that patients are aware of their liability. Document using appropriate message codes, all conversations, arrangements, payments into TIER and AS400.

Accounting
:
Batch credit card machines every morning and reconcile payment receipts to ledger. Ensure that credit card slips have patient names and account numbers if available written on the receipt and that the receipts indicate “upfront payment” so that accounting can apply these payments correctly.

Physician Billing
:
Will ensure that all patients are registered accurately and will verify and document all insurance benefits. This will include handling all refund requests, charity applications, email correspondence and the daily submissions of physician charge sheets and census reports.