Posted in Management 9 days ago.
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 Substance Use Disorder (SUD) Insurance Specialist to join our our Arden Hills Business 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 SUD 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:
Verification of Insurance Eligibility/Benefits for OP, SUD, Dietician services
Initiate necessary Authorizations/Referrals as needed
Completing the authorization 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.
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.
New Patient, Referral, Termed, SUD Eval, SUD Orientation, SUDDA, ARMHSDA, CTSSDA, SBDA & 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
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.
Monday through Friday 7:00-3:30 or 7:30-4:00
Nystrom & Associates, Ltd. prides itself on the benefits and compensation offered to staff, including:
Able to work from home after training is complete at our Arden hills Office
Medical & Dental insurance
Ability to work from home after a short, in office, training period.
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)
401(K) Retirement Plan with a generous employer matching program
Supplemental insurances, such as short term disability, cancer insurance, and accident insurance