Reporting to the Director of Operations, the Clinic Financial Services Specialist is a key member of the Eleanor Health team and will support the financial health of our market.
The Clinic Financial Services Specialist can perform any of the duties bellow:
- Review all Community Member financial accounts as it pertains to insurance accuracy
- Ensure all information necessary for insurance billing such as: demographic information, eligibility result, prior authorization, claims address, etc. is accurate and up to date for each account.
- Develop a workflow to review new and existing member accounts on a routine basis
- Maintain a current and comprehensive understanding of insurance, Medicare, Medicaid, Federal, and state laws regarding billing and collection for services
- Understand managed care authorizations and limits to coverage such as the number of visits allowed
- Ensure payer partner prior authorizations are obtained in a timely manner
- Ensure payer partner requirements for appointments are aligned for optimal billing
- Troubleshoot and resolve any registration or insurance related concerns
- Collect copayment for services
- Engage with community members to establish payment arrangements
- Follow HIPAA guidelines when handling member information
- Create reports with action items for MEAS team and Operations Staff
- Conduct insurance eligibility checks through online portals and phone calls as appropriate
- Maintain a collaborative relationship with the MEAS, ACCESS, and RCM teams.
- Ensure that, regardless of the circumstances, members are treated with dignity and respect and always feel at home.
- Other administrative duties as needed
You’ll be a good fit if you:
- HS Diploma Required
- Associates Degree Preferred
- 2-5 years experience working with insurance in a healthcare setting or relevant knowledge
- Familiarly with ICD-10 Codes and CPT Codes
- Excellent written and oral communication skills, organizational skills, and time management skills
- Strong attention to detail
- Current and comprehensive understanding of insurance, Medicare, Medicaid, Federal, and state laws regarding billing and collection for services
- Experience with data entry in an EHR system
- Familiar with HIPAA privacy requirements for member information.
- Expert knowledge of the insurance landscape including service prior authorizations, billing codes and insurance terminology, eligibility/benefits, private and state insurance plans, etc. (just some suggestions)
- Comfortable with ambiguity and taking on a variety of tasks, as needed
- Computer literate and previous electronic medical record (EMR) experience required
- Experience working with substance use disorder and/or opioid use disorder patients is preferred, but not required
- Strong interpersonal communication skills with exceptional active listening abilities
- Highly empathetic, non-judgmental, and open-minded
- Experience in a collaborative team environment
- Mission driven and motivated to join an organization that will transform the way we deliver accessible, evidence-based, and clinically excellent care in the substance use disorder space
- Able to work across teams and functions, self-starter who quickly identifies what needs to be done and takes ownership
About Eleanor Health
Eleanor Health is the first outpatient addiction and mental health provider delivering convenient and comprehensive care through a value-based payment structure. Committed to health and wellbeing without judgment, Eleanor Health is focused on delivering whole-person, comprehensive care to transform the quality, delivery, and accessibility of care for people affected by addiction.
To date, Eleanor Health operates multiple clinics and a fully virtual model statewide across Louisiana, Massachusetts, New Jersey, North Carolina, Ohio, and Washington, delivering care through population and value-based partnerships with national and regional payors, employers, and other stakeholders.
If you are passionate about providing high quality, evidence based care for individuals with substance use disorder through an innovative practice, and about building a great business that makes a difference, Eleanor Health is an ideal opportunity for you. We seek highly skilled, motivated and compassionate individuals who take responsibility and adapt quickly to change to join our deeply committed and collaborative team.
Job Type: Full-time