Insurance Services Specialist

The Insurance Services Specialist is responsible for submitting and collecting payments from insurance companies for various companies of Embark.  This job opportunity is suited for a skilled insurance billing specialist who can independently coordinate and manage all phases of insurance billing for mental health services.

• Ensure timely and accurate verification of benefits for commercial and Medicaid insurance coverage as related to Behavioral Health coverage
• Ensures the validity and integrity of all patient insurance records
• Ensure timely and accurate processing of invoices and claims; responsible for submitting clean electronic and paper claims to insurance companies
• Responsible for investigation and correction of rejected claims from clearinghouse and/or insurance companies
• Responsible for timely responses to insurance denials, monitoring for trends, and providing feedback on operational processes
• Responsible for working A/R aging report while maintaining account status records and collection efforts in centralized note system
• Responsible for processing and responding to requests for information and records from insurance companies
• Responsible for timely response on requests for refunds as received from insurance company; requests will be validated for accuracy and challenged when not accurate
• Responsible for invoicing of patient co-pays and deductibles, private pay collections and A/R management
• Monitor assigned accounts to identify overdue payments and issue refunds on overpayments
• Make recommendations on adjustments, refunds, and outside collection activity in alignment with company policy and procedures
• Partner will utilization review team to ensure timely billing to third party payors
• Participate in regular billing coordination meetings and provide feedback for problem solving with A/R issues
• Engage in cash application process, making sure all cash receipts are applied accurately and timely
• Provide feedback to program on how to ensure compliance while maximizing revenue

• A minimum of 2 years prior work experience in medical billing and accounts receivable, preferable in a medical or behavioral-healthcare environment
• Experience with electronic claims filing
• Working knowledge of Windows-based applications, including Outlook, Word and Excel
• Hands-on experience with accounting software and familiarity with MS Excel to include strong analytical skills
• Strong and professional communication skills
• Skilled in negotiation and problem-solving aptitude
• Patience and ability to manage stress and maintain confidentiality
• Excellent written and verbal communication skills
• Exceptional organizational skills and attention to detail

Embark Behavioral Health is a unique organization comprised of extraordinary programs dedicated to bringing the current all-time high rates of adolescent anxiety, depression, and suicide to all-time lows within the decade while becoming the most recognizable, respected, and valuable behavioral health organization in the world.  

Embark is a leading network of clinical and therapeutic programs (residential treatment centers, young adult transition programs, outpatient centers, addiction treatment facilities, wilderness therapy programs, support services, and more) that offer a comprehensive set of services that run the span of acuities, ages, and services.  All programs offer state-of-the-art therapeutic interventions, lead the way in quality standards, deliver measurable outcomes and are all tied together via a shared set of core values (empathy, service, trust, growth, and results).