Job Description:
This position is responsible to coordinate the community resources program available to behavioral health patients and community members. This position will also assist patients referred from Behavioral Health, the Emergency Department, and other units along with the community on how to access available mental health resources in their area. The Behavioral Health Navigation Coordinator will assist the Manager in hiring, onboarding, training, and evaluating team members. They will also be responsible to monitor the quality and data collection to identify improvement opportunities and solutions.Scope
- Maintains and develops partnerships and clear lines of communication with insurance representatives throughout the insurance industry who can provide precertification authorization guidelines unique to the individual insurance plan.
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- Works with health insurance providers to validate insurance coverage, benefit limits, eligibility, orders, referral requirements and financial responsibility and conveys this information to the clinical team, patient, and family.
- Navigates the patient revenue cycle in order to assist the RSC with obtaining maximum and timely reimbursement.
- Interviews and registers patients in a prompt, professional, courteous and confidential manner.
- Schedules visits and the registration for assigned specialty department and accurately obtains the required information for hospital records, governmental requirements, billing and third party payer needs.
- Carries out specific processes in the patient scheduling/registration systems so that correct special billing and revenue processes function properly.
- Assists in directing patient flow.
- Provides timely and accurate financial estimates for both self-pay and insured patient populations. Collects amounts owed for medical services, including contacting the patient to secure prompt payment. Reviews paid and/or processed accounts to ensure that the appropriate adjustments and payments were received.
- Reviews daily caseload to ensure all payer specific billing and authorization requirements have been met.
- Ensures accuracy of charge capture for Physician billing including validation of charges submitted, charges are aligned with consistent Federal, State and payor guidelines
- Assists with follow-up on appeals and denials.
- Networks with peers at the RSC to ensure system policies and procedures are upheld.
- Collaborates with both hospital and clinic staff, patient access leadership, and clinic leadership to serve as an advocate for patient care.
- Promotes mission, vision, and values of SCL Health, and abides by service behavior standards.
- Performs other duties as assigned.
Minimum Qualifications
Required
High school diploma or equivalent is required
Three (3) years of experience in a registration, healthcare billing, financial counseling or pre- authorization role
Experience reading and understanding payer remittance advice Includes the ability to differentiate between allowed charges, contractual adjustments, line item denials/reasons, patient responsibility (co-pay, co-insurance, and deductibles), etc. is required
Preferred
Certified Application Counselor (CAC) and/or CHAM, CHAA (within 3 months of starting the role)
Experience in more than at least two areas of registration, healthcare billing, financial counseling or pre-authorization is preferred
Physical Requirements
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements list must be representative of the knowledge, skills, minimum education, training, licensure, experience, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Regular attendance to perform work on site during regularly scheduled business hours or scheduled shifts is required.
- Intermediate comprehension of registration, fiscal information and referral processes.
- Proficient knowledge of internal and external systems relating to scheduling and registration.
- Ability to be self-motivated and work independently is critical to the success of this position. Additionally, strong process improvement and critical thinking skills are a positive.
- To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements list must be representative of the knowledge, skills, minimum education, training, licensure, experience, and/or ability required.
Physical Requirements:
- Hearing/Listening, Speaking, Sitting, Seeing, Manual Dexterity, Standing, Walking.
Location:
West PinesWork City:
Wheat RidgeWork State:
ColoradoScheduled Weekly Hours:
40The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$17.59 - $30.24We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers , and for our Colorado, Montana, and Kansas based caregivers our commitment to diversity, equity, and inclusion .
Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.