Client Access Representative

Position Summary:  

The Client Access Representative reviews insurance policy information, confirms demographic information on file with the insurance plan aligns with our system and accurately verifies coverage and authorization needs for all services offered at The Emily Program.  

Schedule:

Monday-Friday, 9am to 5:30pm CST   

Duties and Responsibilities:  

• Verify insurance benefits for all clients in all regions using payer websites, payer IVR systems and via direct phone contact. 

• Monitor the team’s worklist throughout the day and complete all benefit verifications on time. 

• Ensure the Practice Management System is set up to bill all services correctly, including customizations, as needed, for accurate billing.  

• Complete monthly verifications for all active clients within the staff member’s assigned caseload. 

• Complete daily insurance eligibility checks for clients admitting to care the following business day. 

• Respond quickly and accurately to questions about coverage, benefits and authorization needs from internal stakeholders (e.g. Office Manager, Client Account Team, Utilization Reviewers, Admissions, etc.) Initiate process to add new payers in EHR system 

• Complete all assigned billing tickets within the response guidelines set for the team based off the ticket type to ensure the team is meeting their KPI related to open billing tickets. 

• Triage insurance denials related to eligibility benefits and coordination of benefit issues in partnership with the Revenue Cycle Management and Client Account teams.  

• Assist in reviewing and updating reference materials with known coverage, authorization and exclusion information for all payers.  

• Appropriately document and track insurance-related waivers (e.g Advanced Beneficiary Notice) that require a timely client signature.  

• Actively participate in the onboarding and orientation of new team members. 

• Assist teammates, as needed, to ensure the team’s KPIs are met each week. 

• Complete all tasks based off the assigned caseload split each day. 

• Complete all other duties as assigned to meet needs of department and/or organization. 

Education Qualifications: 

• High School Diploma Required 

 Professional Qualifications: 

• Minimum of 1 year experience in healthcare office environment, behavioral health industry and/or insurance company is required.  

• Understanding of and experience with insurance benefits and authorization requirements is required. 

• Significant experience using Microsoft Office - Word, Excel, PowerPoint, Outlook 

 Competencies: 

• Ability to manage time both independently and effectively for optimal productivity. 

• Strong attention to detail and commitment to quality. 

• Solid interpersonal skills with the demonstrated ability to develop and maintain productive relationships. 

• Demonstrate initiative and exercise good judgement (e.g., in starting tasks, asking questions, identifying and discussing problems, ability to structure own work, stay on task). 

• Ability to prioritize and adapt to changing priorities. 

• Shows passion for our business, clients, and values. 

 Workplace Environment:  

• Requires long periods of sitting (95% sitting, 5% standing) 

• Extensive computer use