Client Services Specialist

Description

The Client Services Specialist is responsible for managing all the stages of Partners In Excellence benefit checks, submitting medical records, and requesting referral/authorizations/single case agreements for our rehab services.  This position will work closely with potential client family members, insurance companies, and our Partners In Excellence clinical staff.  This role plays a critical part in ensuring successful outcomes of turning a client lead into an actual client utilizing our services.

Essential Functions

• Accountable for managing all the stages of our rehab authorizations process:
• Upon client acceptance into any Partners in Excellence programs, this position is accountable for obtaining any required rehab prior authorizations
• Perform insurance verification and benefits check to secure funding
• Communicate insurance benefits with families
• Obtain and complete authorization requests, in-network exceptions, or single case agreement forms when required
• Will be responsible for gathering all clinical data to submit along with authorization requests for payers who require prior authorization approval for our rehab services
• Send completed authorization forms and clinical documents to respective insurance companies for approval by fax
• Communicate receipt of prior authorization to clinical staff
• Enter authorizations into our EMR system
• Fulfill medical records requests through fax, mail or electronically
• Enter client demographic information into all appropriate systems when instructed
• This position will be accountable for tracking all prior authorizations for rehab services and is responsible for ensuring all required prior authorizations are timely renewed
• Research insurance payors requirements
• If a billing issue arises regarding prior authorization, this role is expected to research and fix the issue
• Learn ABA authorization process and fulfilling ABA medical records requests to cover other employees’ absence when necessary
• Generate all required authorizations reporting
• Accountable for annual benefit check process
• Must meet the physical demands listed below
• Complete all other projects/duties assigned

Supervisory Responsibilities
This position has no supervisory responsibilities.

Computer Skills
To perform this job successfully, an individual should have knowledge of computers/software.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

This is largely a sedentary role; requiring sitting or standing at work station using computer equipment and phone for extended periods of time. May need the ability to lift up to 25 lbs. While performing the duties of this job, the employee is regularly required to communicate and interact with people inside and outside the organization. Demonstrates excellent interpersonal, written and verbal communication skills with a clear understanding of English language (reading, writing and speaking). Specific vision abilities required by this job include close vision, distance vision, color vision, and ability to adjust focus.

Work Environment

This job operates in a clinical therapy environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, printers and fax machines.

Other Duties
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Qualifications

Required Education and Experience 

• High school diploma or equivalent
• 3 years of medical intake processing, prior authorizations, medical records tasks
• Experience working with an EMR/billing system

Preferred Qualifications

• Associates degree with relevant medical office coursework
• Knowledge of insurance payor websites/portals
• Exceptional aptitude for customer service
• Outstanding written and verbal communication skills
• Excellent attention to detail
• Ability to work with minimal supervision
• Problem solving skills
• Proficiency in safeguarding confidential information
• Strong organizational skills

Salary : $22 - $25