Insurance Coordinator

This is a fully remote position, open to applicants in United States.

📋 Description

• Report directly to the Insurance and Billing Manager.

• Assist families of ABA learners in understanding eligibility, pre-authorizations, and both government-sponsored and private insurance plans.

• Ensure the maintenance of documentation for learners and therapists as required by insurance providers.

• Submit necessary documentation to obtain or renew authorizations via the third-party billing company.

• Enter or review billing and insurance submissions for the third-party billing organization.

• Offer guidance to learner families regarding plan eligibility requirements and resolve any eligibility and billing concerns.

• Serve as a trusted adviser and primary contact for learner families and clinicians regarding insurance-related questions.

• Investigate and resolve issues related to insurance.

• Assist with billing inquiries and Explanation of Benefits (EOBs).

• Confirm deductibles and project out-of-pocket expenses; aid families in setting up payment plans.

• File appeals for any authorization denials.

• Manage pre-authorizations and documentation requirements for learners.

• Verify learner eligibility and benefits through online payor portals and the third-party billing organization.

• Coordinate paperwork for grants, hardship waivers, and Medicaid eligibility.

• Review daily and weekly billing for accuracy and ensure claims are submitted within required timelines.

• Collaborate with clinical staff and family outreach to assess facility availability and openings.

• Communicate with internal and external stakeholders via email and phone.

• Support regular internal and external record audits.

• Engage in continuous improvement to develop new skills during changing initiatives.

• Safeguard confidential information and adhere to HIPAA, PHI, security, and confidentiality policies.

⛳️ Requirements

• Bachelor's degree preferred or equivalent professional experience.

• A minimum of 2 years of experience in insurance verifications, pre-authorizations, and billing within a clinic or behavioral health context.

• Proven experience in resolving sensitive customer service issues related to authorization, billing, and payment for behavioral health services.

• Strong analytical skills for receiving, organizing, and reporting on data records.

• Exceptional attention to detail.

• High level of self-motivation and energy, with the ability to work independently with minimal supervision.

• Excellent organizational and time management capabilities.

• Strong oral and written communication skills.

• Ability to build working relationships with leadership, clinical teams, and other relevant contacts.

• Capacity to support multiple team members and projects simultaneously while prioritizing effectively in a fast-paced environment.

• Proficiency in Excel and the Microsoft Office Suite, including Word, Adobe, PowerPoint, Outlook, and Teams.

• Capability to work collaboratively as part of a team with strong interpersonal skills.

• Commitment to confidentiality and trustworthiness, including adherence to HIPAA, PHI, and patient communication protocols.

• Compliance with company and departmental policies regarding security, compliance, HIPAA, and confidentiality.

🏝️ Benefits

• Competitive salary and benefits package.

• Opportunities for professional development and growth.

• Supportive work environment with a focus on team collaboration.