SUMMARY

Coordinates with all Red Rock sites to determine, verify and establish payer sources.  Sets up All Funding Sources in the computer system, enrolls new/existing consumers in DMH eligibility as needed, verifies insurance eligibility/coverage, verifies insurance for upcoming appointments, maintains all insured financial information and assists with funding and financial related calls.   

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

• Responsible for the verification of insurance for all Red Rock consumers
  • Daily Appointment Schedule
  • OHCA TPL reporting
  • Weekly PICIS reports
  • Follow-up on Missing or Incomplete Consumer Information
  • Daily Default Monitoring
• Establishes all funding sources for each Red Rock site and enters all required data into the computer while maintaining a high level of accuracy, professionalism and integrity 
• Documents an appropriate level of detail to maintain an accurate account of eligibility history
• Coordinates with payers including, but not limited to: Medicaid, contractors, commercial insurance companies, etc. by phone, fax, email or online portal, to obtain insurance benefits and eligibility information
• Communicates all necessary information to each Red Rock site as needed including insurance terminations, etc.
• Identifies consumer responsibility to include any co-pay, co-insurance and outstanding deductible and notes the account accordingly
• Maintains knowledge of Red Rock’s financial procedures and adheres to all financial guidelines. 
• Assists in educating staff in each Red Rock site regarding funding needs/changes
• Attends staff meetings, workshops, and seminars to learn agency policies, rules, regulations, and procedures; participates in ongoing in-service training as well as pertinent external training
• Performs other duties as required

QUALIFICATIONS

• One year of related healthcare experience and/or training; or equivalent combination of education and experience
• High school diploma or equivalent

OR

• Equivalent combinations of education and experience
• Ten key, computer/data entry, spreadsheets, and word processing
• Ability to work independently, with diligence and accuracy
• Analytical and problem-solving skills
• Detail oriented, with excellent organizational skills
• Excellent verbal and written communication skills
• Commitment to the mission of Red Rock BHS
• Preferred one year of related experience

PHYSICAL REQUIREMENTS

• Must have the ability to stand or sit for long periods of time
• Must have the ability to lift, push, or pull a minimum of 25 pounds
• Ability to travel approximately 10% of the time
• Ability to use telephone, PC, fax machine, copy machine, and printer

HOW WE TAKE CARE OF YOU!

• We pay a generous portion of your Health Insurance
• Low-cost Dental and Vision Insurance
• Retirement Plan with employer contributions equal to 5% of annual salary
• Student Loan Repayment Options
• No Cost Employee Assistance Plan
• 3 Weeks Paid Time-Off (increases annually between years 2-10)
• 9 Paid Holidays
• 1 Floating Holiday to use at your discretion.
• 4 Rest and Relaxation Days
• 3 days of Education Leave
• 4 hours of Volunteer Leave
• Eligible for Pay Increases and Bonuses Annually
• Employer Paid Long-Term Disability and Life Insurance

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

Red Rock Behavioral Health Services does not discriminate based on race, color, national origin, religion, gender, gender identity, age, marital/familial status, sexual orientation, or disability.