Client Insurance Specialist
10 days ago
Athens
Job Description We are seeking a Client Insurance Specialist Southeastern, OH Join our team! Integrated Services for Behavioral Health (ISBH) is a community-minded, forward-thinking behavioral health organization helping people along the road to health and well-being. We meet people in their homes and communities and help connect them to their needed resources. We serve Southeastern and Central Ohio with a comprehensive array of behavioral health and other services – working with local partners to promote healthy people and strong communities. Our services are intended to be collaborative and personalized for the individual. The financial counselor serves as the organization’s primary resource for insurance coverage, self-pay support, communication, and education. This position is responsible for monitoring client insurance renewals and coverage changes, educating staff on payer requirements and processes, serving as an escalation point for complex insurance-related questions and providing information on self-pay options and good faith estimates to patients served. The specialist works collaboratively with clinical, intake, billing and leadership teams to support continuity of care and maximize client access to behavioral health services within an Ohio community mental health setting. The pay range for this position is $20.97-$24.56 per hour based on experience, education, and/or licensure. Essential Functions • Provide staff education and consultation regarding insurance coverage, payer requirements, eligibility verification, and authorization processes for clients., • Develop workflows, reference materials, and process improvements to strengthen client insurance communication and navigation across the organization., • Serve as the escalation point for complex client insurance questions, coverage concerns, and payer-related barriers affecting client care., • Monitor and communicate client insurance renewals, dropped coverage, eligibility changes, payer updates, and coverage limitations to staff and departments., • Extract, track, and organize client insurance renewal and coverage data within the electronic health records systems (ECR/HER) to support continuity of care and operational workflows., • Communicate with clients to implement self-pay agreements, provide good faith estimates, and collect payments when applicable., • Maintain and distribute internal communication lists and updates related to client insurance changes impacting services or billing., • Collaborate with patients, direct service providers, intake, billing, scheduling, and clinical teams as needed to ensure accurate and current client insurance information., • Track Medicaid, managed care, commercial insurance, and OhioRISE or waiver-related changes that impact authorizations or service access for clients, • Collaborate with utilization review, prior authorization, and billing staff to resolve client insurance issues and minimize service interruptions, • Utilize data tracking and analytics to identify trends, coverage gaps, and operational needs related to client insurance management and access to care, • Maintain compliance with HIPAA, mandated reporting requirements, and professional ethical guidelines, • Travel with designated service areas, • All other duties as assigned Minimum Requirements: Education: • A high school diploma/GED is required, • An associate or bachelor’s degree in healthcare administration, social work, business, behavioral health, or related fields is preferred Experience: • 2-3 years of experience in behavioral health insurance verification, authorizations, billing support, utilization review, or healthcare coverage navigation is required, • Experience working within a community mental health or healthcare environment is preferred. Knowledge, Skills and Abilities: • Advanced communication skills, both oral and written is required, • Advanced organizational skills are required, • Knowledge of Ohio Medicaid, managed care organizations, behavioral health benefits, and payer authorization processes is required, • Ability to?maintain?confidential information?is?required?, • Ability to adhere to all safety, rules, regulations and requirements, • Ability to manage multiple priorities and collaborate effectively across departments is required, • Ability to document services accurately and efficiently in an electronic health record, • A valid driver's license and the ability to?operate?a motor vehicle is?required?, • An appropriate level?of auto insurance coverage is?required?, • Ability to operate in an Internet-based, automated office environment is required, • Ability to maintain high-speed internet connection is required, • Data entry, reporting, and spreadsheet management skills is required, • Proficient in Microsoft excel, word and outlook is required Physical Requirements: • Prolonged periods of sitting at a desk and working on a computer is required, • Must be able to lift up to 15 pounds at times is required Enjoy a great work environment with an excellent salary, generous paid time off, and a strong benefits package! Benefits include: • Medical, • Dental, • Vision, • Short-term Disability, • Long-term Disability, • 401K w/ Employer Match, • Employee Assistance Program (EAP) provides support and resources to help you and your family with a range of issues. To learn more about our organization: https://ISBH.org/ OUR MISSION Delivering exceptional care through connection OUR VALUES Dignity - We meet people where they are on their journey with respect and hope Collaboration - We listen to understand and ask how we can best support the people and communities we serve Wellbeing - We celebrate one another's strengths, and we support one another in being well Excellence - We demand high-quality care for those we serve, and are a leader in how we care for one another as a team Innovation - We deeply value a range of perspectives and experiences, knowing it is what inspires us to stretch past where we are and reach towards what we know is possible The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this position. It is not to be construed as an exhaustive list of duties performed by the individuals in this role, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. We’re an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.
