Insurance Specialist

Central City Concern is an innovative nonprofit agency providing comprehensive services to single adults and families in the Portland metro area who are impacted by homelessness, poverty and addictions. We hire people that are skilled and passionate to meet our mission to end homelessness through outcome-based strategies which support personal and community transformation.

The Insurance Specialist works as part of the Billing and Business Information Systems Dept (BBIS) to manage the accuracy of data entry for each patient provided services at many clinics. Responsibilities include entering all Patient Registrations, verifying insurance eligibility and benefits, manage Primary Care Assignments, Prior Authorizations, posting charges and payments, and assisting patient's as needed with Business Office inquires

Location: MUST RESIDE IN OREGON OR WASHINGTON STATE OR BE WILLING TO RELOCATE.

• This position is primarily remote, however you must be within a 3hr radius to 232 NW 6th Ave. Portland, OR 97209.

Schedule: Monday - Friday, 8:00am - 4:30pm

Compensation: starting at $23.39/hr

MINIMUM QUALIFICATIONS:

• High school diploma or equivalent.
• Minimum one (1) year current experience insurance coding, billing, and accounts receivable processes in a medical clinic or behavioral health setting.
• Proficiency in MS Office Suite.
• Current and thorough knowledge of billing, insurance processing, follow-up, and managed care requirements-with a primary emphasis on the Oregon Health Plan.
• Current and thorough knowledge of ICD 10, CPT and HCPCS codes preferred.
• Knowledge of HIPAA regulations and ability to maintain patient confidentiality.
• Experience with Electronic Health Records and EPIC preferred.
• Federally Qualified Health Center (FQHC) experience preferred.
• Ability to adhere to Central City Concern's drug-free workplace which encourages a safe, healthy and productive work environment and strictly complies with the Drug-Free Work Place Act of 1988. An employee shall not, in the workplace, unlawfully manufacture, distribute, dispense, possess or use a controlled substance or alcohol.
• Physical ability to bend, stoop, kneel, squat, twist, reach, pull and lift heavy objects.
• Must pass a pre-employment drug screen, TB test, and background check.
• Must adhere to agency's non-discrimination policies.
• Ability to effectively interact with co-workers in a team atmosphere, clients with diverse ethnic backgrounds, religious views, cultural backgrounds, lifestyles and sexual orientations, and treat each individual with respect and dignity.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Enter client information into CCC Health Service databases to capture demographics, financial and all other required information.
• Verifies patient insurance eligibility and benefits using any of the automated systems, web-based utilities and automated voice verification lines and enters into Practice Management System, daily and monthly.
• Obtain and maintain authorizations for services as required by insurance carrier.
• Manage Primary Care Provider assignments by established insurance carrier guidelines.
• Ensures accuracy of data entered of all Demographic and Billing information.
• Serves as a resource to the clinic, clients and BBIS for all billing questions and inquiries.
• Scan incoming documents into computer for tracking.
• Create appointments and post charges.
• Post payments to patient accounts; work denials, low payments, and over payments and rebill as necessary.
• Assures annual financial evaluation update is completed for each client annually.
• Respond to correspondence and phone calls relating to insurance issues.
• Ensures compliance with established payer guidelines, third party reimbursement policies and reporting regulation guidelines
• Contact with clients to set up payment plans as necessary.
• Update, maintain and distribute reports to staff in order to assist with client's treatment according to established procedures.
• Adhere to all state and federal privacy regulations, including HIPAA and 42 CFR Part 2, and to CCC policies and agreements regarding confidentiality, privacy, and security. Support compliance with all privacy and security requirements pursuant to community partners' and outside providers' patient confidentiality agreements, including privacy and security requirements for EMR access. This includes immediately reporting any breach of protected health information or personal identification information of any person receiving CCC services by CCC or an outside provider to the CCC Compliance Department, as well as to your supervisor or their designee.
• Attend all mandatory CCC trainings in a timely manner.

DESCRIPTION OF OTHER DUTIES:

• Pursue insurance companies for client eligibility verification for appropriate reimbursement for services.
• Back up for other Business Office positions as needed.
• Inform providers/ staff on insurance changes and procedures.
• Send claims electronically daily, primary and secondary; correct rejects and resubmit.
• Captures informational error trends and provides those consistently to BBIS Management, along with suggestions for improvement.
• Perform other duties as assigned.

SKILLS AND ABILITIES:

• Ability to consider the impacts and outcomes for underserved communities during decision-making process.
• Ability to consider impacts of oppression, structural racism, and individual bias on client outcomes.
• High level of accuracy and attention to detail.
• Swift and accurate ten key/data entry capabilities
• Accurate keyboarding at least 60 wpm; accurate 10-key use; good maneuverability with Microsoft Word, Excel and Access.
• Ability to uphold the highest level of professionalism at all times both internally and externally.
• Proven experience as a creative problem solver.
• Ability to work independently with minimal supervision.
• Excellent communication skills, both orally and written.
• Excellent time management skills; ability to meet deadlines.

Benefits: Central City Concern offers an incredible benefits package to our Regular/FT employees:

• Generous paid time off plan which provides up to 4 weeks of PTO accrual in the first year. Accrual increases with longevity.
• Amazing 403(b) Retirement Savings plan with competitive employer match with 4.25% in the first year, 6% in the second year, and 8% in the 3rd year.
• 11 recognized Holidays PLUS 2 Personal Holidays.
• Comprehensive Medical, Vision, and Dental insurance coverage.
• Employer Paid Life, Short Term Disability, AND Long Term Disability Insurance!
• Sabbatical Program offering extended time off at years 7, 14, and 21.

This description is intended to provide a snapshot of the work performed and is not designed to contain a comprehensive inventory of all duties, responsibilities, and qualifications required of the position.

As an agency deeply rooted in recovery, part of our policy and commitment to a drug and alcohol-free workplace includes post-offer, pre-employment drug screens. Please note we follow Federal Guidelines regarding prohibited substances, even for those legal at the state level.

Central City Concern is a second chance employer and complies with applicable laws regarding consideration of criminal background for employment purposes. Government regulations, contractual requirements, or the duties of this job may require CCC to conduct a background check and take appropriate action to address prior criminal convictions.