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Company SummaryIf you are searching for a fulfilling place to develop your career and an opportunity to make a difference in helping others, then keep reading on. Here at AAC, we have a progressive culture; we listen to your ideas, value a work/life balance, invest in education, and we foster trust and respect for all individuals. Our exceptional comp and strong benefits include company matching 401K, employee stock purchase program, 6-week paid maternity, paternity leave, medical, dental, vision and life insurance. We are looking for our future leaders, who are not only going to fill the qualifications for this job description, but who are going to exceed expectations. Be a part of a team whose mission is to provide quality, compassionate, and innovative care to adults struggling with addiction and co-occurring mental health disorders. Our purpose and passion are to empower patients, their families, and our communities by helping individuals achieve recovery and optimal wellness of the mind, body, and spirit. Job Duties:
Make outbound calls to insurance companies to ensure eligibility and coverage for new and recurring clients seeking admission into one of our treatment facilities. Maintains composure throughout call, even when difficulties or communication barriers arise during the course of the call
Analyze patient eligibility and benefits and review presenting problem (diagnosis) to determine clinical appropriateness using ASAM Criteria and Insurance Medical Necessity Guidelines; documents client benefits and estimates LOC for proper placement decision
Inputs data and estimates LOC with accuracy (goal of 95% or better), ensures finished outcome/placement is high-quality, and places accuracy ahead of speed in performing job duties
Communicate client benefits and placement information clearly and concisely to Treatment Consultants/Treatment Consultant Managers and clients
Perform pre-claims authorization for clients prior to admission
Serve as a financial counselor responsible for estimating a client’s financial responsibility based on coverage information obtained
Relay necessary information in a concise manner to peers and clients/family members prior to admission
Serve as a resource for Treatment Consultants/Treatment Consultant Managers and their clients, Interventionists, and referral partners on matters relating to client insurance questions and out of pocket cost
Follow detailed processes and procedures as set forth by department managers to ensure a safe and accurate admission
Communicates effectively and concisely with both peers and individuals outside the organization; clarifies purpose and importance of topic, stresses major points, and communication follows a logical sequence. Asks well-prepared, thoughtful questions, and effectively builds trust and open communication. Able to speak persuasively, convincingly, and reassuringly when needed to facilitate open communication.
Applies knowledge of technical tools and healthcare methodologies to daily tasks, and serves as a source of institutional/industry knowledge to others.
Committed to ongoing learning; keeps abreast of latest healthcare rules and regulations relevant to job role
Perform day-to-day responsibilities with little supervision
Able to perform in a team environment; shares important and/or relevant information with peers, adheres to team expectations and guidelines to fulfill team responsibilities, and assumes new responsibilities when the opportunity arises
Consistently looks for ways to improve personal performance as well as process improvement for the team; accepts/acts upon constructive criticism and feedback from clients, Treatment Consultants/Treatment Consultant Managers, peers, and supervisors
Job Requirements:
High School Diploma or GED equivalent (Bachelor Degree preferable)
2 – 5 years hospital verification and/or utilization review experience
Knowledge of managed health care and commercial plan
Knowledge of medical terminology; knowledge of behavioral health terminology preferred
Prior call center experience; prior experience in a patient-care setting and/or insurance verification environment preferred
Understanding of medical criteria
Prior case management pre-certification preferred in addition to verification
Excellent communication skills
Basic PC skills and Microsoft office skills (Internet explorer, Word, Excel, PowerPoint)
Salesforce experience preferred
Experience with online tools such as Emdeon, Navinet and Availity
If in personal recovery, a minimum of 2 years clean and sober
AAC is committed to principles of equal opportunities for all employees. The Company will provide reasonable accommodations that are necessary to comply with State and Federal disability discrimination laws.Job ID: 2019-3100 External Company Name: American Addiction Centers External Company URL: http://contactaac.com Street: 200 Powell Place
Vacancy expired!