Benefits Investigator Coordinator at Mindful Health Solutions in San Francisco, California

Job Description:

OVERVIEW:

Mindful Health Solutions is a leading outpatient psychiatry group practice dedicated to freeing patients from the burden of mental illness. We are transforming outpatient mental healthcare by providing the most advanced, evidence-based treatments available, including Transcranial Magnetic Stimulation (TMS) and Esketamine therapy. TMS is a highly effective, non-invasive, FDA-cleared therapy for drug resistant depression. Esketamine is an FDA-approved, prescription nasal spray for patients with treatment resistant depression.

Led by nationally recognized clinical experts in psychiatry and entrepreneurial healthcare business leaders, we offer compassionate, comprehensive mental healthcare. Our team-based work culture of innovation, learning and collaboration support our core values of Accountability, Credibility and Transparency. Our architect-designed medical clinics are specially designed to provide patients, practitioners, and employees with a modern, relaxed, people-centered experience.

Mindful Health Solutions has several across California with plans to expand out of state. 

For more information about our company, please visit www.mindfulhealthsoutions.com

Mindful Health Solutions is recruiting a Benefits Investigation Coordinator to work on ensuring the care we provide to our patients and is covered by their insurance carrier. In addition, this role will include duties associated with our Treatment Access Team.

Responsibilities

• Must Verify and do a complete benefit breakdown for Mental Health/ Tele-Psych/TMS/ESK Benefits for all Internal and External Interventional Consults or Referrals via on-line and phone verification
• Must enter all information accurately into our EHR system
• May be required to contact patients if they are not eligible and obtain new insurance info and verify.
• Must escalate all inquiries to a supervisor in the event we have received inconsistent or inaccurate information based on patient’s feedback (i.e. deductible met, copay is to high)
• Provide additional coverage and back up to TAS Team by completing the necessary prior authorizations and correspondence required by insurance companies to approve patients for TMS/ESK therapy
• Provide support for denied insurance authorizations by analyzing/investigating/filing appeals on denials and peer-to-peer requests.
• Participates on a team for data collections, health outcomes reporting, clinical audits, and programmatic evaluation related to initiatives

Qualifications

• Experience, knowledge, and an understanding of what Co-pays, Co-Insurance, OPM/DED, in-network and out of network mean as it pertains to verification of benefits and eligibility.
• Understanding of Coordination of Benefits- Primary verses Secondary
• Must have experience with EHR systems
• Attention to details
• Must have healthcare and or Insurance experience