INTERNAL ONLY - Insurance Change Specialist

Summary:   Reporting to the Benefits & Eligibility Manager this role supports the operations of the Action Behavior Centers, LLC (ABC) Revenue Cycle Management (RCMN) team to communicate all aspects of financial changes to our patients' families.   

Duties and Responsibilities:

• Schedule meetings with all new ABC patients and existing ABC patients that have had changes to their existing insurance coverage to review the impact of ABC policy related to their patient responsibility.
• Review the verified benefits with the family to confirm the Maximum Out of Pocket (MOOP) and the expected financial responsibility for treatment.
• Explain the ABC billing process to educate the family on how their insurance will be billed and how the patient billing process works.
• Confirm all patient demographic data and primary contact information (phone, email, address, etc.)
• Collect credit card information and get approval for monthly payment deductions based on the expected patient responsibility and entering those details into Salesforce.
• Review obligations of the family if there are any changes/updates to their employment or insurance coverage.
• Confirm completion and submission of charity care application and required supporting documentation.
• Contact patients as Coordination of Benefit (COB) issues arise based on communication from the RMC team or directly from the payors.
• Contact patients after statements have been generated to set up payment plans where one is not currently present.
• Handle all communications with families in a courteous and professional manner, interact with sensitivity and be responsive to their individual needs.
• Receives and places telephone calls in a skillful manner using appropriate language.
• Handle all telephone requests with courtesy, accuracy, and respect for confidentiality while following all HIPAA regulations for privacy.
• Perform miscellaneous job-related duties as assigned.

Knowledge, Skills and Abilities Required:

• Ability to manage high volumes of work and organize/maintain a schedule independently.
• Ability to communicate effectively, both orally and in writing
• Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community.
• Understanding of the RCM process overall preferred but not required.

Minimum Job Requirements:

• High School Diploma required, Bachelor’s Degree in Business/Management or related area (or current enrollment in a similar program) preferred.
• 2 years’ experience related to the duties and responsibilities specified.