Customer Account Specialist

Lighthouse is seeking a full time individual who can perform client intake and account oversight, healthcare billing functions, and general accounting duties for Lighthouse. Works with internal and external customers to obtain, update, and interpret client account information. The Customer Account Specialist will have the training and, preferably, the experience to be able to deliver services outlined below.

Job Duties:

Customer Accounts Specialists may be assigned specific primary tasks and/or distinct client or payer populations for primary accountability and oversight.

• Reviews and updates client accounts timely to ensure accurate demographic and account information, including insurance information, grants and fee agreements.
• Receives incoming questions from clients, payers and/or clinicians regarding client accounts; initiates data submission for any additional information needed, and interprets information back to the client, payer and/or clinician.
• Reviews, monitors, updates and prepares Client Record to insure required Intake/Registration forms and data are completed and updated as necessary.
• Coordinates client’s application process for public assistance. Updates client record accordingly (internal and external systems) and monitors assigned client records to ensure adequate coverage for services.
• Verifies insurance coverage, co-payment, and coordination of benefits and updates client billing information accordingly.
• Reviews, monitors, updates and ensures timely submission and follow up for payer authorizations
• Monitors assigned clients to ensure services are scheduled appropriately based on insurance coverage.
• Prepares paperwork for self-pay accounts to be sent to collections and adjusts self-pay balances when accounts are sent to collections.
• Maintains current knowledge regarding public payers, third-party and first-party payment procedures and regulations.
• Monitors dashboard and runs reports daily to monitor and initiate corrective actions as necessary to insure accuracy and completeness of billing, service and charge information for timely submission.
• Processes daily mail payments and Explanation of Benefits that accompany payments.
• Reviews charges for accuracy and generates claims for billing to payers and/or clients and follows up timely on claim generation errors.
• Enters payments received and balances input to deposit.
• Investigates denials from payers and initiates timely follow up.
• Monitors aging and takes action to ensure timely filing and payment of claims.
• Balances monthly payments deposited to payments posted in billing software.
• Responsible for reviewing closed cases for client overpayments and submitting requests for client refunds.
• May provide CPST/case management services to ensure access to and coordinate benefits to ensure clients receive the maximum benefits for which they are eligible.
• Keeps current with trends and developments related to essential job competencies, and demonstrates continued growth.

Requirements:

• Certificate in Medical Billing or an associate degree in business, healthcare, accounting or closely related field required, or may substitute four years related experience in lieu of degree.
• Demonstrated knowledge and understanding of health/behavioral health billing procedures and eligibilities for third-party providers preferred.
• Strongly prefer prior experience in customer service and behavioral health setting.
• Must have strong attention to detail and be able to communicate (verbal and written) effectively with a variety of individuals.
• Competent computer/PC skills using Microsoft Office 365, Excel, and electronic health record systems.
• Must be able to work independently and meet deadlines
• Must be honest, dependable, self-disciplined, organized and be able to work well as a team member.