Insurance Verification & Authorization Specialist

Job Description:

Since 1936, Easterseals NH has been an unwavering force, transforming lives across all ages and abilities through our dynamic programs. Our dedicated efforts empower individuals to not only enhance their health and well-being, but also attain greater independence, triumph over substance use, cultivate essential life skills, access education, secure stable housing, build stronger family connections, and engage deeply with their communities.
We are seeking an Insurance Verification & Authorization Specialist to join our team! The individual in this key position will provide an overview of the treatment delivered to each individual client in a designated caseload to obtain and ensure payor authorization for services, and monitor and evaluate each client’s clinical documentation for elements essential for concurrent reviews and overall record integrity. Additional responsibilities include:

• Review the overall client record to gather clinical information needed to obtain payors’ authorization for all services provided or to be provided by Farnum to clients.
• Complete concurrent reviews with payors for authorization of continued level of care, internal step-downs to lower level of care, and transfers out, notifying payors and other appropriate entities of client discharges.
• Anticipate upcoming reviews and work with assigned clinician and/or case manager to ensure proper documentation is complete.
• Verify daily the authorized days for entire assigned caseload and obtain additional authorization from insurance carriers or other entities as needed.
• Monitoring and evaluating each client’s clinical documentation for elements essential for concurrent reviews and overall record integrity.
• Ongoing verification of clients’ eligibility and coverage of services by insurance carrier, NH Medicaid, MMIS (daily check) and state funded resources.
• Establish and maintain positive, effective relationships with insurance vendors and clinical staff
• Contact clients and/or clinicians with any insurance issues.
• Enter authorization numbers and other information into EMR and patient contact log.
• After contacting insurance provider, enter verification of benefits (VOB) into EMR.
• Run Outpatient reports daily (by 8:30am) to notify Outpatient staff

Qualifications:

• High School Diploma or equivalent and five (5) years’ in substance use disorder environment experience and three (3) years’ experience in a related field
• Associates Degree in a related field preferred
• Exceptional verbal and written communication skills and ability to articulate care plans to payors of treatment service
• Critical thinking and problem-solving skills
• Knowledge and understanding of the American Society of Addiction Medicine (ASAM) criteria
• Valid driver’s license and reliable transportation

Hours: This is a full-time (40 hours a week) with a Monday - Friday schedule. Hours are 8:00am to 4:30pm.



Compensation: $20 an hour

What’s in it for you? We offer a comprehensive benefits package for full-time, eligible employees, including:

Medical, Dental, Vision, Life & Disability
PTO begins accruing on your first day!
10 Paid Holidays – includes a floating holiday of your choice
403(b) employer match up to a maximum of 3%
Tuition reimbursement after one year of employment
Student loan repayment for qualifying degrees after one year of employment
Wellness programs: nutritional counseling services, reimbursement programs for weight loss & tobacco cessation
We are proud to be a recovery-friendly workplace and a NH Veteran-Friendly Business.



To learn more about this role, please click on the blue “Apply Now” button below to submit your application. Have questions about the role? Schedule time to chat with our Talent Acquisition Specialist, Bill: www.calendly.com/eastersealsnh-bill/15min


Difficulty submitting your application or scheduling time to chat? Contact Bill at 603-670-6817 or WStavropoulos@eastersealsnh.org.


EOE

Salary : $20