Client Financial Services Representative

Job Description

Job Description

About the Job

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General Statement of Duties:

This position plays a crucial role in supporting the financial aspects of client care within HRCSB. This position is responsible for managing client financial information, verifying insurance coverage, assisting with financial intakes, resolving billing and insurance claim issues and ensuring that clients have a clear understanding of their financial responsibilities related to services provided. The position serves as a key point of contact for clients and insurance companies as appropriate, ensuring a seamless financial experience in a supportive and compassionate manner.  This position reports to the Reimbursement Supervisor.

This position is classified non-exempt under the provision of the Fair Labor Standards Act.

Major Essential Functions:
Client Financial Intake:

• Conduct financial intake for new and existing clients, gathering necessary demographic, insurance, and financial information. Works collaboratively with Client Account Representative to cover in-person financial intakes for clients.
• Explain financial policies to clients, including payment plans, co-pays, and insurance coverage. For self-pay clients, provides standard fees for each client in accordance with the agency policy and established sliding scale fee schedule, completes fee agreement forms, processes fee appeals for Reimbursement Supervisor/CFO approval, and scans all required documents in EHR system, attached to the client records.
• Ensure accurate entry of all client information into the electronic health record (EHR) or billing system.

Insurance Verification:

• Verify insurance eligibility and coverage for behavioral health services, including checking for in-network benefits, co-pays, and deductibles.
• Communicate with insurance companies as needed to resolve coverage or billing discrepancies.

Billing and Claims Management:

• Monitor and follow up on claim denials, rejections, and underpayments, working with insurance companies to resolve issues promptly.
• Assist with resubmitting corrected claims and appeals to ensure accurate reimbursement.
• Maintains up-to-date knowledge of third-party and other payers’ requirements in order to assist with notifications within the electronic health record and maximize reimbursements from those sources of revenue.

Client Billing and Collections:

• Communicate directly with patients regarding their financial responsibilities, including statements of services and payment expectations.
• Updates client contact information as appropriate.
• Address patient inquiries related to billing issues, such as discrepancies in charges, insurance coverage, or payment plans.
• Assist patients in understanding their insurance benefits and any out-of-pocket costs, offering solutions for payment arrangements when necessary.
• May assist in the collection procedures of client overdue accounts (legal action, set-off debt).
• May assist with preparing and sending necessary paperwork to maintain CSB information with the state Set-Off Debt (SOD) Collection program, including processing Add, Change, and Update Forms under the direction of the Reimbursement Supervisor.

Customer Service and Support:

• Provide compassionate and professional support to patients and their families regarding financial matters related to behavioral health services.
• Collaborate with clinical staff, case managers, and other departments to ensure accurate financial documentation and service delivery.

Compliance and Documentation:

• Maintain accurate records of all financial transactions, communication with patients, and insurance interactions.
• Stay up-to-date on insurance policies, regulations, and compliance requirements in the behavioral health field.
• Ensure that all activities comply with relevant federal, state, and local regulations as well as organizational policies.

Problem Resolution:

• Work proactively to resolve billing issues, payment discrepancies, and other financial concerns for clients in a timely and empathetic manner.

Collaboration and Team Support:

• Collaborate with clinical and administrative teams to ensure timely and accurate processing of financial information and payments.
• Participate in training sessions to stay informed about industry changes and new financial procedures.
• Maintains effective relationships with co-workers and clients based on courtesy, compassion, and respect.
• May back up other departmental functions or perform other duties and special projects as assigned consistent with established operational policies and procedures.

Required Knowledge, Skills and Abilities:

• Knowledge of insurance processes, claims adjudication and reimbursement procedures.
• Work independently, coordinate responsibilities and assignments with others at the appropriate level. Ability to seek and use supervision appropriately.
• Make decisions and initiate action based on established policies and procedures.
• Ability to explain complex payment/billing issues in an understandable manner to others who don’t have the billing knowledge.
• Demonstrate knowledge of computer operations in automated accounts receivable systems, office procedures and equipment;
• Perform detailed work in an accurate, efficient, and professional manner.
• Provide excellent customer service internal and external.
• Ability to understand and follow oral and written directions.
• Strong organizational, communication-both oral and written and interpersonal skills.
• Ability to be a team player within the department, agency and external to others. Flexibility with work duties.
• Maintain confidentiality of client and staff at all times.

Minimum Educational Experience:
Completion of high school or GED required.  Additional education, certifications or work experience preferred which could include college or business school courses; plus two- three years of experience in relevant customer service or administrative support work;  reimbursement and third-party billing experience a plus; or any equivalent combination of experience and training which provides the required knowledge, skills, and abilities.

Other Information:

• Equipment: PC and designated software, adding machine/calculator, copy machine, fax machine, printer, document scanner, and telephone system.
• Work Environment: General office environment with normal lighting levels, temperature ranges, air quality, ventilation, and noise levels.
• Work Location: 1241 North Main Street Campus, Harrisonburg, VA
• Work Hazards: Some hazard associated with repetitive motion necessary for data entry/ typing; standard hazards associated with human services environment.
• Work Schedule: Hours will occur Monday – Friday between 8am – 5pm; hours scheduled as needed to meet agency operational needs.

HIPAA Access Level 3: Read-only access to protected health information (PHI), limited to minimum necessary, and full read/write access to demographic and financial information, limited to the minimum necessary, for all clients as part of staff provision of support services in agency health care operations.  Staff at Level 3 are allowed to seek out client PHI as necessary to perform assigned duties, but are expected to exercise due precautions to avoid exposure to PHI which is not necessary to perform these assigned duties.  Utilization of information will be in accordance with HIPAA regulations regarding use limitation, disclosure and requests of PHI.

Position Salary Range :$40,270 to $49,066 annually
Actual starting salary will be commensurate with the selected candidates’ education,  experience, and qualifications.