Insurance Verification and Authorization Specialist

Northeast Arc • Danvers, MA

2d • $29 • Onsite

About The Position

Northeast Arc is seeking a detail-oriented and proactive Insurance Verification & Authorization Specialist to support our Specialty ABA Services Division! Job Summary: Manages all aspects of insurance verification and coordination for clients enrolled in ABA Services. Ensures timely and accurate collection, verification and maintenance of insurance information to support service delivery and billing compliance. Collaborates with administrative staff and program leadership to troubleshoot insurance issues and maintain payer readiness.

Requirements

• Minimum of 2 years of experience in insurance verification, and healthcare administration.
• Minimum of 1 year experience in authorizations for ABA services.
• High School Diploma or Equivalent.
• Strong understanding of insurance processes including Medicaid, commercial insurance, and managed care plans.
• Proficiency in electronic health records (EHR) and data systems.
• Excellent analytical and problem-solving skills, with the ability to interpret complex data and make informed decisions.
• Knowledge of HIPAA regulations to ensure client confidentiality is maintained at all times.
• Strong attention to detail and ability to work independently while managing multiple tasks efficiently.
• Excellent communication skills, both verbal and written, to interact with clients and healthcare professionals effectively.

Nice To Haves

• Familiarity with Early Intervention regulations and service models.

Responsibilities

• Verifies insurance eligibility for all clients at the time of referral.
• Acts as a point of contact for clients explaining insurance coverage, answering benefit questions, and providing clear information regarding out-of-pocket expenses.
• Contacts insurance companies to secure authorizations for all required services.
• Works in collaboration with program directors and BCBAs on ensuring authorizations are accurate and up to date.
• Troubleshoots insurance-related issues, including coverage denials, coordination of benefits, and missing information. Navigates insurance portals and online tools, resolves billing discrepancies, and provides documentation and updates as needed.
• Ensures accurate and up-to-date client and insurance data entries in electronic health records (EHR) system, maintains consistency and accuracy.
• Other duties and special projects as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 251-500 employees