What are the responsibilities and job description for the Insurance Verification Specialist position at Light Counseling?
BENEFITS
- Competitive Medical, Dental, and Vision Plans*
- Retirement Plan with Employer Match*
- Continuing Education (After Probation)*
- Work Laptop
- Paid Time Off - 5 Holidays and 20 Days Off
* Employee must be full-time in order to be eligible for these benefit
ABOUT LIGHT COUNSELING:
Since 1991, Light Counseling has served more than 100,000 Individuals, Couples, & Families with professional, confidential, and distinctly Christian counseling services in Virginia and eight (8) other states! We take pride in incorporating God’s truth in the helping process. Our mission is to bring hope to the hopeless and healing to those who are hurting by helping individuals realize their God-given, divine potential.
DESCRIPTION
We are seeking a detail-oriented and organized Behavioral Health Insurance Verification Specialist to join our team. This role is critical in ensuring that patients receive seamless care by confirming active insurance coverage, verifying patient responsibility for behavioral health services, and obtaining pre-authorizations as required. The Specialist will also prepare Good Faith Estimates (GFE), communicate directly with patients about their financial responsibilities, and provide feedback and training to Intake Specialists on insurance verification trends and tips. This position will handle various forms of communication, including phone calls, emails, and other communication mediums, to interact with patients, insurance companies, and internal departments. Additionally, they will collaborate with other departments to address errors identified during the verification process, such as credentialing issues or tax ID discrepancies. When not performing insurance verification duties, the Specialist will assist the Billing Manager with various billing tasks.
LEVEL OF RESPONSIBILITY
Employment with Light Counseling is of a confidential nature and operates in accordance with federal and state privacy laws and practices (i.e. HIPAA). All work is performed under supervision, but does require the ability to effectively function independently, with flexibility, initiative, maturity and decision-making within the framework of Light Counseling policy and procedures.
DUTIES AND RESPONSIBILITIES
Insurance Verification
• Confirm insurance eligibility and benefits for behavioral health services, including copays, deductibles, and coverage limitations.
• Verify pre-authorization requirements and obtain pre-authorizations for services as necessary.
• Maintain accurate and up-to-date patient insurance information in the system.
• Communicate with insurance carriers to resolve discrepancies or obtain additional details.
• Notify patients of their financial responsibility before appointments and explain their coverage and payment options.
• Prepare and provide Good Faith Estimates (GFE) in compliance with the No Surprises Act.
Patient Communication
• Engage with patients to provide clear explanations of their insurance benefits and financial responsibilities.
• Assist patients with questions or concerns about insurance coverage, billing, and payment processes.
Training and Collaboration
• Notify and train Intake Specialists on trends, best practices, and tips for effective insurance verifications.
• Collaborate with Intake Specialists to ensure accurate and efficient patient onboarding processes.
• Work with other departments, such as credentialing and compliance, to resolve issues affecting insurance verification (e.g., credentialing discrepancies, tax ID errors).
• Communicate findings and provide feedback to ensure accurate processing and prevent future errors.
Billing Support
• Assist in submitting claims to insurance companies accurately and in a timely manner.
• Review and resolve denied or rejected claims.
• Post payments and adjustments to patient accounts.
• Respond to patient billing inquiries and provide clear explanations of charges and account balances.
• Support the Billing Manager in preparing monthly reports on billing and collections.
MINIMUM QUALIFICATIONS
• High School diploma or equivalent.
• High school diploma or equivalent (Associate degree or higher preferred).
• Minimum of 1-2 years of experience in medical or behavioral health insurance verification, billing, or related roles.
• Familiarity with behavioral health billing codes (e.g., CPT, ICD-10) and insurance requirements.Ability to organize and prioritize work and manage multiple priorities
• Ability to analyze data and develop effective solutions.
• Related experience in customer service
• Strong attention to detail
• Moderate computer proficiency
• Excellent communication skills and the ability to interact professionally with patients, providers, and insurance representatives.
• Be proficient with Microsoft Office 365
• Complete all required background checks and drug testing.
PREFERRED QUALIFICATIONS
• Certification in medical billing and coding (e.g., CPC, CHC).
• Experience with behavioral health services or practices.
