INSURANCE BENEFITS SPECIALIST - KidsPeace Childrens Hospital

Job Summary

The Benefits Specialist is responsible for verifying, processing and updating all client medical insurance and/or medical assistance information and posting this information in the KidsPeace electronic client files. These responsibilities include communications with client guardians and referral sources as needed in order to secure updated and accurate information.

Job Duties

• Verify medical insurance benefits for all new admissions to KidsPeace Hospital and Residential programs as assigned and enter this information into the KidsPeace electronic record
• Review medical expenses charged to KidsPeace for insurance or medical assistance benefits and communicate this information to Providers
• Seek reimbursement from Referral Sources or Guardians for non-covered medical expenses as per KidsPeace contracts or other agreements
• Provide data relating to dollars saved by utilizing client insurance coverage on a quarterly basis
• Hire, train, supervise and evaluate performance of front desk reception staff
• Communicate verbally and in writing all benefits information to the Admissions Department, Business Office, Treatment Team, and Utilization Review
• Periodically review insurance coverage on established clients and update electronic records as needed
• Recruit and maintain schedule for Hospital Reception at Front Desk. Provide coverage for Front Desk Reception when necessary
• Hire, train, supervise and evaluate performance of front desk reception staff

Qualifications

• High School diploma or equivalent required. Bachelors Degree in business preferred or at least 5 years experience working with insurance companies, managed care companies, or Medical Assistance (preferable psychiatric)
• Understanding of case management
• Must have the ability to work evenings, weekends, holidays, flexible hours and overtime as required
• Must be at least 21 years of age
• Valid driver's license required

PI253419860