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 afull-timeInsurance Specialistto join our West Des MoinesBusiness office. 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 servicesInitiate 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 multitaskingExtreme ability to organize and track large amounts of dataVerification Benchmarks are met on a time frame as established by Management.FlexibilityNew 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 requirementsPolicies 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 policyInitial Authorizations are set up in Allscripts PM according to authorization policyPatient Accounts are noted appropriately in EEHR and PMRecognize/report trends and patterns with providers & clinicsRecognize/report trends and patterns with insurance companiesBack up Authorization Specialist with Authorization requests & approvalsOpen communication with Supervisor & LeadArrive and leave on time according to assigned scheduleAdhere to attendance policies
Qualifications:
Experience working with Excel preferredAbility to work on dual monitorsAbility to work in multiple software programsMinimum 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- 8am-4:30pm OR -7am-3:30pm
Benefits:
Nystrom & Associates, Ltd. prides itself on the benefits and compensation offered to staff, including:
Medical & Dental insuranceOpportunities for professional growth and career advancementHealth Savings Account (HSA)Flexible Spending Account (FSA) for applicable medical and dependent care expensesPaid Time Off (PTO)Paid Holidays401(K) Retirement Plan with a generous employer matching programSupplemental insurances,such asshort term disability, cancer insurance, and accident insurance
