Client Insurance Specialist
$43,618–$51,085 year
On-siteColumbus, Ohio, United States
Job Summary
Monitor client insurance renewals, coverage changes, and eligibility updates while extracting and tracking data within electronic health records. Provide staff education on payer requirements, authorization processes, and self-pay options, serving as the escalation point for complex insurance questions and coverage barriers. Collaborate with clinical, intake, billing, and utilization review teams to resolve service interruptions and implement workflows that strengthen client communication. Communicate directly with patients to manage self-pay agreements and good faith estimates, maintaining compliance with HIPAA and mandated reporting standards. Track Medicaid, managed care, and OhioRISE changes impacting authorizations, utilizing data analytics to identify trends and operational needs. Maintain internal communication lists regarding insurance changes and ensure accurate documentation of services.
Required Qualifications
- A high school diploma/GED
- 2-3 years of experience in behavioral health insurance verification, authorizations, billing support, utilization review, or healthcare coverage navigation
- Advanced communication skills, both oral and written
- Advanced organizational skills
- Knowledge of Ohio Medicaid, managed care organizations, behavioral health benefits, and payer authorization processes
- Ability to maintain confidential information
- Ability to adhere to all safety, rules, regulations and requirements
- Ability to manage multiple priorities and collaborate effectively across departments
- 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
- An appropriate level of auto insurance coverage
- Ability to operate in an Internet-based, automated office environment
- Ability to maintain high-speed internet connection
- Data entry, reporting, and spreadsheet management skills
- Proficient in Microsoft excel, word and outlook
- Prolonged periods of sitting at a desk and working on a computer
- Must be able to lift up to 15 pounds at times
- Travel with designated service areas
Desired Qualifications
- An associate or bachelor's degree in healthcare administration, social work, business, behavioral health, or related fields
- Experience working within a community mental health or healthcare environment
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