Insurance Verification Specialist

Insurance Verification Specialist

Location: Devou Park

Department: Billing Services 

Position Reports to: Director of Billing Services         

Position Supervises:   n/a                       

Profile Last Updated: April 24, 2024

QUALIFICATIONS

• Minimum of 2 years' experience working in verification of insurance benefits.
• Familiarity with behavioral health services preferred but not required.
• Experience with CareLogic electronic health record system preferred.
• Experience in billing and coding is preferred but not required.
• Demonstrated history of successfully building relationships with insurance companies and their representatives.
• Self-motivated and able to prioritize and identify processes that need to be implemented and/or improved, and tasks that need completion.
• Above-average organizational and time management skills, with great attention to detail.
• Strong verbal and written communication skills.
• Demonstrated proven sensitivity to the various cultural and socioeconomic characteristics of the CHNK Behavioral Health’s (CHNK) clients and staff.
• Alignment with the Sanctuary Institute’s trauma informed care model and the Human Rights Campaign’s All Children All Families initiative in LGBTQ+ competencies. CHNK is certified in both models.
• Valid drivers’ license or other ability to travel between CHNK sites in a timely manner required.
  
  

POSITION SUMMARY
The Insurance Verification Specialist is responsible for verifying insurance coverage and benefits for CHNK Behavioral Health outpatient services programs. Responsibilities include upload of appropriate documentation into the CareLogic EHR system, verification of required insurance coverage and benefits, providing cost estimates for clients, and working with other departments such as outpatient and prior authorization.

ESSENTIAL JOB FUNCTIONS

1. Upload documentation into the CareLogic Electronic Health Record (EHR).
2. Input insurance information into the EHR and verify insurance coverage/benefits and coordinate primary and secondary benefits.
3. Participate in Verifying patient insurance benefits.
4. Provide insurance coverage breakdown of costs, including co-payments, co-insurance, and services needing pre-authorization. Contact insurance companies to gather necessary information for verification and coordination of benefits.
5. Perform as a subject matter expert in reading, understanding, interpreting VOBs (verification of benefits) to advise the team on policies that will not pay enough to cover the daily operation cost per patient.
6. Manage the resolution of insurance billing errors.
7. Verify Medicaid and other client insurance eligibility monthly or as required.
8. Provide back up support to Director of Revenue Cycle Management for insurance concerns.
9. Participate in agency Performance Quality Improvement and Quality Assurance Committee activities.
10. Must be able to perform the essential functions of this position with or without reasonable accommodation.
11. Attend training as required.

BENEFITS

Our full-time associates are eligible for the following benefits to support them as they help us improve the lives of others.
*Thirty-seven paid days off
    13 Paid Holidays
    18 days of PTO plus an 6 additional days of time off for illness of 3 or more days.
*Four weeks of paid family leave (new child or care for a family member) after 1 year of employment
*Student Loan Repayment Assistance up to $10,000 over the course of employment beginning after 6   months of employment
*Tuition Reimbursement of up to $5,000 per year
*Retirement Plan with 6% employer match
*Medical Plan with Zero Deductible*Dental, Life, LTD, STD, and Vision
*Flexible Spending Account
*Employee Assistance Program
*Free Parking
*Dog-friendly environment at some locations (bring your pet to work)

CHNK is an Equal Opportunity Employer