Suncoast Center, Inc. · 14 hours ago
Customer Experience Administrative Insurance Specialist
St. Petersburg, FL
Full-time
Onsite
Mid Level
3+ years expSuncoast Center, Inc. is a community mental health agency seeking a Customer Experience Administrative Insurance Specialist. This role involves managing client accounts, handling billing issues, and ensuring accurate insurance information to maximize revenue while working closely with various departments and maintaining high customer service standards.
CharityHealth CareMental HealthNon ProfitWellness
Responsibilities
Complete all daily, weekly, and monthly Avatar management reports related to agency-wide admissions, guarantor set-up, and insurance changes
Answer client phone calls, updating client accounts and addressing client issues regarding finance/billing issues
Work closely with Authorization specialist to ensure authorizations are processed in an accurate and timely fashion
Monitor reports daily, weekly, monthly related to admissions, guarantor/insurance changes to correct/verify client financials: ensuring accuracy
Complete and monitor client insurance verification to ensure accurate guarantor set-up during the enrollment period and update periods when required
The Reimbursement, Central Intake, Enrollment, and Utilization Departments work together to ensure client information is entered and updated for all clients in the electronic medical record system (Avatar)
Coordinate with the department managers in the screening, and interviewing of new hires for the department
Work as a cohesive team member focused on a common goal to ensure accuracy of the insurance information to maximize revenue
Other duties may include data entry of insurance data, addressing denied or rejected claims, investigating coding issues, updating client records and making sure of overall billing compliance in line with insurance guidelines and regulations
Participate in access, billing, and other system coordination meetings as needed
Work as a cohesive team member focused on a common goal
Other Duties as Assigned
Qualification
Required
Minimum of an Associate's Degree required with two year of experience in a behavioral health or medical office setting with experience in front desk operations, billing, and customer service required
Three years or more experience in a healthcare setting, knowledge of admission requirements in a healthcare setting
Exceptional knowledge of NetSmart Avatar or other electronic medical records, working with Medicare, Medicaid and third party outpatient insurance claims and denials utilizing an EHR
Must possess Knowledge of ICD-10CM, CPT and HCPCS, including coverage levels, rules/regulations, fee schedules and contracted services
Demonstrated understanding of quality assurance and monitoring of reports; ability to work autonomously while maintaining proactive communication with supervisor and other departments
Ability to demonstrate strong organizational skills
Excellent customer service abilities, excellent written and verbal communication skills, and cultural competence skills; ability to work effectively with a multi-disciplinary team in a fast-paced, changing environment
Must be 21 years of age or older
Negative Drug Screening prior to hire and throughout employment
Clear Criminal Background Check throughout employment with Suncoast Center and local checks prior to hire and annually along with DCF Level II prior to hire and as required by DCF
Must have valid Florida Driver's License Motor Vehicle checks prior to hire and annually with acceptable driving record maintained throughout employment along with reliable vehicle, valid registration, and valid vehicle insurance
Must be proficient with Microsoft Word, Outlook, and Excel
Must be proficient with electronic medical record systems including admissions, financial enrollment, and website portal navigation, Electronic Health Record comprehension
Preferred
NetSmart Avatar experience a plus
Company
Suncoast Center, Inc.
Suncoast Center has been serving the residents of Pinellas County since 1944.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Jean D. Pierre
CEO
Company data provided by crunchbase