Customer Experience Administrative Insurance Specialist

Job Duties

• Complete all daily, weekly, and monthly Avatar management reports related to agency-wide admissions, guarantor set-up, and insurance changes.
• Answer client phone calls, updating client accounts and addressing client issues regarding finance/billing issues.
• Work closely with Authorization specialist to ensure authorizations are processed in an accurate and timely fashion.
• Monitor reports daily, weekly, monthly related to admissions, guarantor/insurance changes to correct/verify client financials: ensuring accuracy.
• Complete and monitor client insurance verification to ensure accurate guarantor set-up during the enrollment period and update periods when required.
• The Reimbursement, Central Intake, Enrollment, and Utilization Departments work together to ensure client information is entered and updated for all clients in the electronic medical record system (Avatar).
• Cook up with the department managers in the screening, and interviewing of new hires for the department.
• Work as a cohesive team member focused on a common goal to ensure accuracy of the insurance information to maximize revenue.
• Other duties may include data entry of insurance data, addressing denied or rejected claims, investigating coding issues, updating client records and making sure of overall billing compliance in line with insurance guidelines and regulations.
• Participate in access, billing, and other system coordination meetings as needed.
• Work as a cohesive team member focused on a common goal.
• Other Duties as Assigned

Core Competencies

• The ability to function and operate as a team player, showing dignity and respect for all.
• The ability to comply with all equal employment opportunity and ethical standards and regulations.
• The ability to take direction in a respectful and productive manner from supervisors and managers.
• The ability to work, as scheduled, in a timely fashion, and with an attitude oriented to service.
• The ability to have cordial and professional relationships both within the organization and with vendors, clients and third parties.
• If appropriate, the ability to produce all appropriate paperwork and reports consistent with contractual, state or federal standard, and to prepare and submit such paperwork on a timely basis.
• The ability to understand and comply with Suncoast Center, Inc. policies and procedures.
• The ability to render compassionate care and equal commitment to serve clients in need of healthcare assistance.