Job Details

Position Summary

The Billing Assistant reports to the CFO and actively involved in all clinical activities in order to maintain ongoing contact with managed care and insurance companies for the purpose of providing progress reports and obtaining authorization for various levels of care and length of stay for Hina Mauka clients in accordance with policies and procedures, and insurance guidelines. Protects the confidentiality of client's records in accordance with all applicable federal regulations.

Position Accountabilities

1. Essential Functions

1. Coordinates with intake personal to ensure that follow ups are conducted on a periodic basis for all initial authorizations.

1. Completes continued authorizations through a collaborative effort with clinical staff or utilize available resources to gather client information to ensure the success of the authorization process. Conduct periodic follow ups on pending authorizations and document in INSPIRE.

1. Assist in monitoring and managing alternate funding sources for clients receiving outpatient services, ensuring that all funding streams are accurately tracked and documented. This includes reviewing and releasing client encounters to maintain up-to-date records of funding utilization, supporting both compliance with agency policies and proper financial oversight of client care.

1. Maintains and updates client insurance information to ensure accurate and up-to-date records. Regularly reviews coverage details, verifies benefits, and communicates any changes as needed to support compliance with funding requirements and ensure uninterrupted client care throughout their stay.

1. Attends morning census meetings and provide insurance updates to staff, assist in updating census board in chart room, communicates with treatment team as to authorization, benefits or changes in level of care approved or denied by insurers, managed care companies or utilization reviewers.

1. Provide updates to authorizations to clinical administration to document on census and/or billing monitor.

1. Conducts telephone updates with managed care and insurance carriers for the purpose of having clients authorization for benefits extended and also have level of care changes approved. Phone update time will be used to inform insurers and utilization review of any changes in the treatment plan, discharge status, progress or aftercare plans.

1. Maintains relationships and communicates with referral sources regarding prospective client to ascertain treatment history/goals.

1. Maintains client records in accordance with Hina Mauka policies and procedures and in compliance with all state and federal laws, licensing and accreditation standards, and contract stipulations.

1. Performs other related duties as assigned.

1. Qualification Requirements

Experience and Training:

1. High School Graduate required, College degree preferred

1. Proficient computer skills, working familiarity with MS Office - Word, Excel, Access and Outlook. Type a minimum of 45 wpm.

1. At least two (2) years experience in office procedures or two (2) years of business office management education.

Knowledge, Skills and Abilities:

1. Knowledge of office procedures.

1. Ability to professionally represent the agency to all referral sources, networking with community agencies, medical professionals, and all potential referral sources.

1. Well organized and able to maintain accurate and concise records.

1. Working knowledge and experience with managed care and other funding sources.

1. Physical/Mental Demands

Light physical effort; mostly sedentary work; occasional standing/walking; occasionally lifts supplies/equipment.

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