Insurance Verification Specialist

BRANDYWINE COUNSELING & COMMUNITY SERVICES INC • Wilmington, DE

13h • Onsite

About The Position

Since 1985, Brandywine Counseling & Community Services, Inc. (BCCS) has been a trusted provider of outstanding substance abuse and behavioral health treatment. BCCS is a community organization that prides itself on helping members of our community recover with dignity. We enhance the quality of life by creatively providing Education, Advocacy, Prevention, Early Intervention, and Treatment Services. We promote hope and empowerment to persons and families touched by mental illness, substance abuse, HIV and multiple occurring diagnoses, and their related challenges. The Insurance Verification Specialist is primarily responsible for verification, authorization, documentation, communication with and problem resolution.

Requirements

• Computer knowledge (Microsoft Office), proficiency with computer systems and insurance portals.
• Writing, analytical and problem-solving skills
• Basic office procedures, including answering telephone, typing and operating business machines, word, and excel.
• Familiarity with medical terminology and insurance plans (HMO, PPO, Medicare, Medicaid). Interprets literature from a variety of sources within the billing department, including medical billing codes, and billing terminology.
• Oral and written communication skills, presentation skills, organizational and computer skills.
• Planning, organizational, and time management skills.
• Attention to detail & time management skills
• Creativity and resourcefulness in problem-solving situations
• High School Diploma
• Minimum of 2 years' experience in Accounts Receivable
• Minimum of 2-years of Insurance Billing/Verification/Collections
• Valid Driver's License with 2 Points or Less.

Nice To Haves

• Associate degree
• Usage of various billing platforms

Responsibilities

• Assist in real-time insurance verification to help front-end staff interpret the collections protocol for each of our payers
• Verification: Confirm active coverage and eligibility via insurance portals or phone calls. Ensure insurance is verified for upcoming appointments.
• Lead insurance verification efforts in real time to ensure that co-pays, co-insurance, and deductibles are met according to the health insurance guidelines daily.
• Pre-authorization & Authorization: Obtain pre-authorizations or referrals required by insurance companies for specific treatment services. Responsible for submitting documentation to support necessity
• Track authorization status and follow up with payers
• Documentation: Accurately update patient records with insurance details, policy limitations, and deductibles.
• Problem Resolution: Address insurance discrepancies and denials to minimize unpaid bills.
• Communication: Advise patients of their financial responsibility and coverage limitations.
• Ensure any changes to client insurance are reflected in EMR at 100% and communicated between the treatment program and billing department.
• Negotiation and Payment Plans: Work with debtors to establish structured repayment arrangements, balancing timely collection approved by Program Manager.
• Report client statement irregularities/mistakes
• Supports staff in assigned project-based work.
• Travel when necessary to a site when the collection process is not followed, and/or when support is necessary

Benefits

• Group medical, dental and vision coverage with low employee costs
• 34 paid days off annually
• Tuition reimbursement
• A retirement plan with a company match of up to 4%!
• Brandywine Counseling is a qualified employer for Public Service Loan Forgiveness (PSLF)
• Opportunity for advancement

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 11-50 employees