What are the responsibilities and job description for the Patient Accounts and Utilization Review Coord position at BEACON BEHAVIORAL SUPPORT SERVICES?
Patient Accounts and Utilization Review Coordinator
1. Support and implement the Mission, Vision, and Core Values of Beacon Management and its holdings.
2. Uphold the policies and procedures associated with the position and the company overall.
SPECIFIC RESPONSIBILITIES AND DUTIES
Insurance Benefit Verification and calculation of Patient Responsibility
- Verify that the patient’s insurance is active and determine coverage benefits, including any copays, deductibles, or coinsurance requirements.
- Document benefits and responsible amounts in the system for future visits and collections.
Collection of Payment and Documentation in System
- Inform the patient of their financial responsibility, collect, and document collections based on the patient collections policy.
- Ensure all information—demographics, insurance details, benefits, and payments—is accurately documented in the patient’s chart.
- Provide the patient with correlating documentation.
- Reconcile collected payments daily and ensure patient responsible portion is captured on the day of service.
- Demonstrate teamwork characteristics, work alongside other billing coordinators to ensure end of month balancing and AR aging decreases.
Utilization Review
- Perform initial pre-certification requesting twenty-one IOP sessions as standard for the seven-week outpatient programming. Request SCA from managed care company for any out of network plans.
- Request concurrent authorization requests.
- Monitor and track authorized days vs days completed.
- Request SCA from payors for any out-of-network plans.
- Enter all authorization information into the EMR system.
- Communicating daily, through email to management, deficiencies that are found.
The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job related tasks other than those stated in this description.
CONTINUING EDUCATION REQUIREMENTS
Personnel are expected to participate in appropriate continuing education as may be requested and/or required by their immediate Member of Management. In addition, personnel are expected to accept personal responsibility for other educational activities to enhance job related skills and abilities.
