Scheduling & Insurance Verification Specialist

About the role

We are seeking a Scheduling and Insurance Verification Specialist to join our dynamic team in Hoboken, NJ. This role offers the opportunity to support individuals on their recovery journeys while learning and refining clinical and engagement skills.

Responsibilities

• Create and maintain a wellness and recovery-oriented environment by using respectful, person-first language, documentation, and interactions.
• Provide the highest quality customer service to all employees and customers, including being friendly, responding promptly, knowing your service, listening to and getting to know our staff and customers, being open to asking, receiving and using feedback, creating positive work relationships, and always following up with assignments.
• Maintain a culture of compliance with internal and external policies, regulations, laws, and high ethical standards.
• Successfully completes the insurance verification and accompanying documentation in the electronic health record.
• Completes all initial documentation on the EHR, including episodes, profile page, and payer information.
• Ensures confidentiality of information gathered.
• Utilizes EMEVS and Navi Net to verify insurance information prior to services, and verifies insurance eligibility on each and every visit, both in person and via telehealth, updating any insurance information as needed in EHR.
• Supports the billing by correctly verifying and documenting insurance coverage, data collection, and data reporting functions, while backing up the central access function.
• Call or access on-line systems to assist in obtaining pre-authorization and prior authorization for services.
• Utilize sliding fee scale with persons served who do not have any coverage.
• Collect co-pays and enter them into EHR.
• Direct, assist, and coordinate with new persons served to complete registration and clinical paperwork through the On-Call and patient portal.
• Runs Business Intelligence Reports on a daily basis, including the Program Census Report, to ensure the accuracy of all information that is entered in HER.
• Screens for basic information, begins EHR file, and links to clinician, with warm handoff, for risk assessment within the same day.
• Responsible for the initial and ongoing scheduling of all appointments, including initial intake, initial psychiatric evaluation, and all subsequent follow-up appointments.
• Ensures that there are open slots available on staff schedules for walk-ins and any other unscheduled appointments, and when no-shows or cancellations occur, proactively follows up with persons served who may benefit from a sooner appointment.
• Is cross-trained on all support services in the same location and ensures that all administrative and support job responsibilities are followed for all services taking place in the same location.
• As a backup to the Central Access function, is responsible for all phone calls and email inquiries to the office and providing information on agency processes or area resources.
• Follows up by virtual access outreach calls to persons served who inquired for services but never completed paperwork, or for those who completed the paperwork but never came in for services.
• Follows up with reminder calls to persons served for appointments or to reschedule missed appointments.
• Meets and greets person served/referral in the waiting area.
• Utilizes positive customer service when answering calls or emails. All calls must be answered "live" and if messages are left, calls must be returned within 2 hours. All emails must be responded to within 3 hours. Faxes must be checked twice per shift.
• Explains to new program enrollees their financial responsibilities for the services, including fee schedules, sliding fee scales, and co-pays.
• Supports CQI efforts and outcome data measurement collection and reporting as well as state, federal, or SAMHSA reporting requirements.
• Ensures ordering of supplies and management of inventories.
• Responsible for monthly American Express submission of receipts, Purchase Orders, and any needed invoicing.
• Provides clerical support to the team as needed.
• As needed, will be trained on and will provide culturally competent follow-up which addresses the diverse needs of the population served and as identified on the needs assessment.

Qualifications

• High School Graduate or equivalent is required.
• Associate’s degree or Graduate of Administrative Assistant/Business School Program is preferred.
• Bilingual Spanish required.
• Excellent interpersonal and customer service skills in working with persons with disabilities and other service provider personnel.
• Billing and data collection experience required.
• No travel expected.

Benefits

• Medical, Dental, Vision, 403b, basic life and AD&D, flexible spending accounts, EAP
• Eligible for medical benefits after 30 days of employment
• Flexible work schedules, clinical training series, leadership development program
• 10 paid holidays (an 11th after 2 years of employment), generous vacation and sick time