What are the responsibilities and job description for the A/R Representative position at Behavioral Innovations?
Overview:
Behavioral Innovations (BI) was founded in 2000 around a passion for helping children with autism. Since that time, BI has developed numerous center-based programs across multiple states and has become a premier choice for treatment. With a commitment to evidence-based interventions and behavioral supports, BI has changed the lives of children and families by delivering the finest Applied Behavior Analysis Therapy available for childhood intervention. BI’s vision is a community in which all children achieve their full potential. The company strives to be trusted by clients, a valued partner in the community and creators of positive change. BI accomplishes its vision by providing client-centered, evidence-based behavioral therapy for children with autism in a nurturing learning environment.
Position Summary:
Duties & Responsibilities
Essential Functions
Requirements:
TX2022
A Little About our Awesome Company:
Behavioral Innovations (BI) was founded in 2000 around a passion for helping children with autism. Since that time, BI has developed numerous center-based programs across multiple states and has become a premier choice for treatment. With a commitment to evidence-based interventions and behavioral supports, BI has changed the lives of children and families by delivering the finest Applied Behavior Analysis Therapy available for childhood intervention. BI’s vision is a community in which all children achieve their full potential. The company strives to be trusted by clients, a valued partner in the community and creators of positive change. BI accomplishes its vision by providing client-centered, evidence-based behavioral therapy for children with autism in a nurturing learning environment.
Position Summary:
This position will focus primarily on reviewing and assessing insurance denials or returned claims. Must be able to communicate with insurance companies from a resolution-based perspective. This communication should be focused on acquired knowledge, insurance carrier guidelines, company policies & procedures, research, and collection efforts.
Duties & Responsibilities
Essential Functions
Bill insurance claims twice weekly- Call Payers to reverify insurance if a denial occurs after first billing
- Identifying and investigating insurance claims issues to resolution/payment
- Initiating claims adjustments and resubmission of claims to the insurance carriers.
- Follows up on claims submitted to ensure prompt and timely payment and escalates issues, as necessary.
- Evaluates payments/denials received for correctness and ensures they are applied accordingly.
- Identifies bad debt write-offs and A/R adjustments. Initiates write-offs and adjustments in accordance with policies and procedures.
- Identifies any overpayments and/or duplicate payments and investigates and resolves accordingly.
- Maintains contact with other departments to obtain patient or insurance information needed for claim payment.
- Responsible for understanding all procedures within regulatory mandates.
- Ensures that the activities of the collection operations are conducted in a manner that is consistent with overall department protocol, and are following Federal, State, and payer regulation, guidelines, and requirements.
- Verifies billing accounts with accounts receivable ledger to ensure that all payments are accounted for and properly posted.
- Documents, in detail, phone calls, phone number, person spoken to, and call details on a consistent basis.
- Resolves issues that created a denial within 5 days of receipt of denial.
- Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
- Maintains a broad range of knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes.
- Timely medical records request for Appeal Process.
- Send secondary claims as soon as primary remit is received to avoid delays with payment.
- Reducing outstanding A/R and aging reports
- Familiar with Electronic Medical Records and Billing Systems.
- Strong interpersonal and communication skills with an ability to work effectively with teams, managers, and executive staff.
- Perform any other duties assigned
Professional:
- Demonstrating and promoting cultural values: Caring, Accountable, Collaborative, and Family-Focused. Adherence to policies and procedures (Code of Conduct, HIPAA, documentation standards, etc.).
Requirements:
- Associates degree preferred, will take five years’ experience in lieu of degree.
- 3-5 years of healthcare industry experience required.
- 3-5 years of medical billing and collections experience required.
- 3-5 years of knowledge in a behavioral health or medical clinic setting preferred, but not necessary.
- Exhibit high quality work
- Use excellent judgment
- Communicate clearly
- Take the initiative to identify and resolve issues
- Willing to learn and take on new tasks
- Demonstrate resourcefulness and cooperation
- Exhibit BI’s core values in all interactions
TX2022
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