Regional Financial Services Specialist Can Be Remote - 901

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u003cpu003eFounded in 1965, Telecare is a rapidly growing mental health care company dedicated to making a difference for our clients, the community, and our employees. We offer an array of mental health services to adults with serious mental illness. We partner with public sector entities and behavioral health organizations, and have over 135 programs and over 3,900 employees across the country. And weu0027re growing all the time! When you work at Telecare, you help to empower thousands of individuals every day in their journeys of recovery.u003c/pu003enu003cpu003eu003cstrongu003eu003c/strongu003eu003cstrongu003ePOSITION SUMMARYu003c/strongu003eu003c/pu003enu003cpu003eThe Regional Financial Services Specialist position is responsible for managing financial eligibility, authorizations and single case agreements. This includes, requesting, tracking, follow up and data entry into the electronic health record system for all admissions for assigned programs in the region. The focus of this position is to work closely with assigned programs to ensure that all clientu0026rsquo;s financial records have accurate payer information upon admission and maintained monthly. The Regional Financial Services Specialist position will require a comprehensive knowledge and understanding of Medicare, commercial insurance and managed care health plans, along with understanding Medi-Cal CERTs to interpret coordination of benefits. This position is a liaison position between the programs and the corporate Revenue Cycle Department.u003c/pu003enu003cpu003eu003cstrongu003eQUALIFICATIONSu003c/strongu003eu003c/pu003enu003cpu003eu003cstrongu003eRequired: u003c/strongu003eu003c/pu003enu003culu003enu003cliu003eHigh school Diploma or G.E.D.u003c/liu003enu003cliu003eMinimum five (5) years professional experience in a healthcare billingu003c/liu003enu003cliu003eAbility to read, write and speak Englishu003c/liu003enu003cliu003eStrong analytical and time management skills and attention to detailsu003c/liu003enu003cliu003eAbility to work and communicate effectively with customers, government representatives, management and staffu003c/liu003enu003cliu003eProfessional knowledge of Medicare, Medi-Cal/Medicaid, managed care health plans and commercial insurance plansu003c/liu003enu003cliu003eKnowledge of CPT, HCPCS and medical terminologyu003c/liu003enu003cliu003eExtensive knowledge of insurance plan benefits and limitationsu003c/liu003enu003cliu003eA comprehensive understanding of managed care health plansu003c/liu003enu003cliu003eAvailability to work overtime, as neededu003c/liu003enu003cliu003eMust be at least 18 years of ageu003c/liu003enu003cliu003eAll opportunities at Telecare are contingent upon successful completion and receipt of acceptable results of the applicable post-offer physical examination, 2-step PPD test for tuberculosis, acceptable criminal background clearances, excluded party sanctions, and degree or license verification. If the position requires driving, valid driver license, a motor vehicle clearance and proof of auto insurance is required at time of employment and must be maintained throughout employment. Additional regulatory, contractual or local requirements may applyu003c/liu003enu003c/ulu003enu003cpu003eu003cstrongu003ePreferred:u003c/strongu003eu003c/pu003enu003culu003enu003cliu003eTwo (2) years college level educationu003c/liu003enu003c/ulu003enu003cpu003eu003cstrongu003eESSENTIAL FUNCTIONSu003c/strongu003eu003c/pu003enu003culu003enu003cliu003eDemonstrate the Telecare mission, purpose, values and beliefs in everyday language and contact with the internal and external stakeholdersu003c/liu003enu003cliu003eFunctions as the primary point of contact between assigned programs and Revenue Cycle for insurance and authorization related issuesu003c/liu003enu003cliu003eDeciphers insurance coverage and benefits to ensure accuracy of all revenue cycle activities for assigned programsu003c/liu003enu003cliu003eAccesses various websites or secure portals to obtain client eligibility statusu003c/liu003enu003cliu003eUpdates the electronic health system (Avatar):nu003culu003enu003cliu003eFinancial Eligibilityu003c/liu003enu003cliu003eAuthorization Managementu003c/liu003enu003cliu003eSingle case agreementsu003c/liu003enu003cliu003eFollow up Entry (Notes)u003c/liu003enu003c/ulu003enu003c/liu003enu003cliu003eMaintain a monthly member benefit tracking record to ensure that month to month benefits remain accurateu003c/liu003enu003cliu003eReviews daily admissions/census for all members served to determine Revenue Cycle intervention appropriatenessu003c/liu003enu003cliu003eMaintains and expands knowledge base on payer requirements for both contracted and non-contracted entitiesu003c/liu003enu003cliu003ePrepare and submit request for authorization of services provided to our clients, including initial authorization, extension or subsequent when neededu003c/liu003enu003cliu003eReview clinical data, diagnosis and procedure codes for authorizing requestu003c/liu003enu003cliu003eIdentify when a single case agreement is necessary, notify program/corporate office and initiate and complete the process; including follow up and Avatar entryu003c/liu003enu003cliu003eTrack status of authorization requests and follows up with payer to ensure authorization is granted, paying close attention to authorization dates spans and service codesu003c/liu003enu003cliu003eResolve any authorization discrepancies with payeru003c/liu003enu003cliu003eActively participate in problem identification and resolution and coordinate resolutions between appropriate parties.u003c/liu003enu003cliu003eCommunicate daily with program staff to secure client information and documentationu003c/liu003enu003cliu003eDevelop and maintain professional, service-oriented working relationships with members served, clinicians, social workers, management and external parties in a courteous and efficient manneru003c/liu003enu003cliu003eAnalyze data, perform multiple tasks and work independently as well as in a team environmentu003c/liu003enu003cliu003ePrioritize daily work and assesses workload situationsu003c/liu003enu003cliu003ePlan, organize, prioritize, and execute multiple, continuing assignments with general instructionsu003c/liu003enu003c/ulu003enu003cpu003eDuties and responsibilities may be added, deleted and/or changed at the discretion of management.u003c/pu003enu003cpu003eu003cstrongu003eSKILLSu003c/strongu003eu003c/pu003enu003culu003enu003cliu003eAbility to use Microsoft Office Suite, including Word, Excel, PowerPoint, etc.u003c/liu003enu003cliu003ePractical knowledge of computer applications for database and presentation, electronic health records, and web-based applications, internet and calendaring softwareu003c/liu003enu003cliu003eExcellent oral and written communication skillsu003c/liu003enu003cliu003eType 40 WPMu003c/liu003enu003c/ulu003enu003cpu003eu003cstrongu003ePHYSICAL DEMANDSu003c/strongu003eu003c/pu003enu003cpu003eThe physical demands here are representative of those that must be met by an employee to successfully perform the essential functions of this job.u003c/pu003enu003cpu003eThe employee is constantly required to sit and occasionally required to stand, walk, reach, twist, bend, pull and lift and carry items weighing 10 pounds or less as well as to do simple grasping. The position requires manual deviation, repetition and dexterity. Visual requirements include computers and books exposure.u0026nbsp;u003c/pu003enu003cpu003eu003cstrongu003eEOE AA M/F/V/Disabilityu003c/strongu003eu003c/pu003e,EqualOpportunityEmployerDescription:Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities,PayTransparencyPolicyStatement:The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c),MatchScore:1.0,HasApplied:false,ApplicationJobBoardName:null,ApplicationJobBoardId:null,DateApplied:null,Salaried:false,CompensationAmount:null,PublishingStatus:1,Links:[],BehaviorCriteria:[],MotivationCriteria:[],EducationCriteria:[],LicenseAndCertificationCriteria:[],SkillCriteria:[],WorkExperienceCriteria:[],JobBoardMemberships:[{JobBoardId:4f54269c-3a81-e250-e075-3a1a05307eef,PublishedInternal:true,PublishedExternal:false,ExternalPostedDate:null,InternalPostedDate:2021-09-29T22:03:04.46Z},{JobBoardId:2fcbb6f4-e717-17cb-9327-3dd87a55b08d,PublishedInternal:false,PublishedExternal:true,ExternalPostedDate:2021-09-29T22:03:04.46Z,InternalPostedDate:null}],AssessmentUri:null,AssessmentStatus:null,OpportunityIsClosed:false,TravelRequired:null,TravelDescription:null,SupervisorName:null,Assessments:[],ApplicationId:null,CompensationAnnualMinimum:null,CompensationAnnualMaximum:null,CompensationHourlyMinimum:null,CompensationHourlyMaximum:null,CompensationCurrency:null});

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