Early Start Co Pay Services

SUMMARY: Under the general supervision of the Behavior Specialist, determine families/clients financial eligibility for regional center payment of copays and/or co-insurance expenses, process insurance plan information, create purchase of services authorizations, ensure Behavior Health Transition (Medi-Cal) services are timely, work closely with Behavior Health Vendors and Insurance companies.

SALARY RANGE:

• $25.4482 - $35.8082

SIGN-ON BONUS!

• $250 sign-on bonus after the completion of 90 days of employment at IRC with work performance in good standing.
• $500 sign-on bonus after the completion of 6 months of employment at IRC with work performance in good standing.
• Make sure to tell us if an IRC employee referred you when you get to that question on your application! Please include their full name.

GENEROUS BENEFITS PACKAGE AND EMPLOYEE PERKS:

• To view our benefits package and employee perks, please click HERE. 

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Upon referral from service coordinator, ensure insurance co-pay and co-insurance assessment information and forms are sent to families/clients. Ensure all pertinent financial and insurance information from families/clients is received.
• Ensure Assessment for financial eligibility for IRC funding of co-pays, co-insurance expenses and Family Cost Participation Program (FCPP) is completed. Ensure the process of insurance documentation: verify type of insurance plan, co-insurance or copayment; maximum out of pocket expenses, and deductible amount. Monitor insurance assessment timelines/dates.
• Ensure notification is sent to family and service coordinator of eligibility determination.
• Be a liaison to insurance companies, vendors and attend all relevant meetings in relation to Behavior Health Services.
• Provide assistance to vendors with Quality assurance issues, billing issues and or Title 17 regulation compliance issues. Work closely with IRC Quality Assurance department when compliance issues are evident.
• Generate purchase of services authorizations by obtaining and reviewing explanation of benefits (EOB) for payment of co-pays and/or co-insurance expenses to be paid by the regional center. Provide final decision on approval of invoices to Purchase of Service (POS) department. Review invoices submitted by vendor with EOB to ensure payments. Coordinate insurance co-pay/co-insurance processes with case management department. Establish and maintain related files.
• Complete Title 19 notes to document important insurance-related information as appropriate.
• Reassess families/consumers annually for Family Cost Participation Program (FCPP), co-pay/co-insurance/deductible assistance.
• Provide insurance co-pay and co-insurance in-service trainings for case management, as needed. Develop training material and participate in training at all levels as instructed.
• On a daily basis maintain an adequate skill level in interpersonal and community relationships.
• Maintain good attendance and punctuality.
• Comply with agency Personnel Policies and Procedures.
• Use equipment appropriately and keep it in good repair. Keep work area neat and orderly and free from hazards.  Observe all safety rules.
• Enter data into Network Server and personal computer (PC).
• Prepare reports as needed or assigned on a timely basis.
• Maintain and update knowledge through readings, briefings, and training.
• Keep director informed of pending work, work in progress, and problems encountered.
• Drive vehicle/travel to other offices/locations as needed or assigned.
• Work cooperatively and effectively with others. Perform as a member of the team, answer questions, share expertise and contribute to the harmony of the team.
• Handle change well and be flexible and adaptable in dealing with interruptions, new priorities, and new assignments.
• Perform different or additional work as assigned.

MINIMUM POSITION REQUIREMENTS:

• High school diploma or equivalent. Bachelor’s degree preferred.
• Three years of experience in fiscal record keeping. Completed courses in bookkeeping and/or medical billing, data entry training required.
• Ability to multi-task, use ten-key calculator, establish priorities to meet deadlines, work independently with initiative to follow through completion of tasks, analyze statistical and fiscal data, make mathematical calculations, maintain detailed and accurate records.
• Knowledge of generally accepted accounting practices, bookkeeping procedures, and terminology.
• computers, basic knowledge of Microsoft Office applications computer office software programs and other office equipment, familiar with online ordering and invoicing. Knowledge of insurance practices highly desirable.
• Ability to handle change well and be flexible and adaptable in dealing with interruptions, new priorities, and new assignments.
• Ability to follow oral and written direction. Good verbal and written communication skills.
• Ability to establish and maintain effective working relationships with others. Ability to work cooperatively and effectively with others. Perform as a member of a team, answering questions, sharing expertise, and generally contributing to the harmony of the team.
• Assure that consumer rights and dignity are maintained in the provision of services.
• Full use of an automobile, possession of a valid California driver's license and liability insurance for the minimum amount prescribed by law or ability to provide for independent transportation. Must have and maintain a safe driving record.
• Bilingual preferred.

We are proud to be an EEO employer. We maintain a drug-free workplace and perform pre-employment substance abuse testing.