Insurance Specialist (Administrative)

Nystrom & Associates, Ltd. is a team of mental health professionals that specialize in psychiatric evaluations, clinical social work, and family therapy. We are committed to helping patients in our community who are experiencing personal, emotional, marriage, family or psychological problems. Founded in 1991, we offer an intensive outpatient chemical dependency program, psychological testing, and behavioral health and medication management services.

We are currently seeking a full-time Insurance Specialist to join our our Arden Hills Business office. After intial in-office training, this role could be fully remote (work from home). In this role you will execute the fast-paced task of verifying insurance eligibility for patients. This role ensures all insurance benefits are verified, provider eligibility is verified per insurance carrier, and authorization requirements are received in a timely manner to ensure optimal reimbursements.

The job duties of our Insurance Specialist focuses on verifying mental health or chemical dependency insurance eligibility, verifying updated insurance information within 24 hours of receipt, obtaining initial authorizations/referrals as needed, and any other duties as assigned by management. Other duties include the following:

Job Duties:

Verification of Insurance Eligibility/Benefits for OP, ARMHS & CTSS services
Initiate necessary Authorizations/Referrals as needed

Completing the auth process as applicable

Appointments are flagged accordingly

Field/Resolve provider/clinic inquiries via Email or Task

Inquiries are followed up within 24 hours of creation

Attend and participate in biweekly staff meetings and any other meetings and/or training sessions as indicated.
All other duties as assigned by Management.

Expectations:

Extreme attention to detail while multitasking
Extreme ability to organize and track large amounts of data
Verification Benchmarks are met on a time frame as established by Management.
Flexibility
New Patient, Referral, Termed , CD Eval, CD Orientation, CDDA, CBDA & CBADA appointments are verified within 2 business days of being scheduled

Are marked with GREEN checkmark to confirm active coverage based on Insurance coverage, Provider exceptions, and Authorization requirements
Policies are set up correctly based on NAL approved Insurance Verification Process

Follow-up appointments are verified by the IVerify system

Any appointments found inactive are followed up on within 1 business day of the inactive verification and communicated to clinical staff.
Manual reverifications of insurance not verified by the automated system are done as needed.

Initial Authorization orders are entered into Allscripts EEHR according to authorization policy
Initial Authorizations are set up in Allscripts PM according to authorization policy
Patient Accounts are noted appropriately in EEHR and PM
Recognize/report trends and patterns with providers & clinics
Recognize/report trends and patterns with insurance companies
Back up Authorization Specialist with Authorization requests & approvals
Open communication with Supervisor & Lead
Arrive and leave on time according to assigned schedule
Adhere to attendance policies

Qualifications:

Experience working with Excel preferred
Ability to work on dual monitors
Ability to work in multiple software programs
Minimum of two years working in health care facilities preferred, particularly with insurance verification and knowledge of prior authorization process.
Familiarity with insurance company guidelines and HIPAA regulations.

Hours:

Monday - Friday, general day time hours

Pay rate:

$18-$19 per hour, based on experience

Benefits:
Nystrom & Associates, Ltd. prides itself on the benefits and compensation offered to staff, including:

Medical & Dental insurance
Opportunities for professional growth and career advancement
Health Savings Account (HSA)
Flexible Spending Account (FSA) for applicable medical and dependent care expenses
Paid Time Off (PTO)
Paid Holidays
401(K) Retirement Plan with a generous employer matching program
Supplemental insurances, such as short term disability, cancer insurance, and accident insurance