Intake Engagement & Billing Specialist MA IC

Vinfen•Lawrence, MA

12d•$50,000 - $50,000•Onsite

About The Position

The Intake, Engagement & Billing Specialist plays a key role in supporting access to services across the agency’s Integrated Care Division as well as connect. This position manages referral and intake processes for multiple care coordination and community-based programs, ensuring individuals are connected efficiently and appropriately to services within the agency’s continuum of care or to external providers when needs fall outside of the agency’s scope. The Specialist is responsible for coordinating referral tracking, client outreach and engagement, insurance eligibility verification, prior authorization and reauthorization activities, and supporting billing-related functions. This role also participates in a centralized Intake & Engagement team and serves as a Certified Application Counselor (CAC) to support the agency’s health insurance counseling and enrollment efforts. Programs supported may include, but are not limited to: Community Support Program (CSP) Community Support Program – Homeless Individuals (CSP-HI) Community Support Program – Justice Involved (CSP-JI) Health-Related Social Needs (HRSN) Housing Supplemental Services One Care Health Home Restoration Center CBHC.

Requirements

Knowledge of community-based behavioral health, care coordination, and human service delivery systems
Understanding of MassHealth, Medicaid managed care, Medicare, and other public health insurance programs
Knowledge of insurance eligibility verification, authorization, reauthorization, and billing processes
Familiarity with Massachusetts behavioral health and social service systems, including CBHC, CSP, HRSN, and Health Home models
Understanding of person-centered, trauma-informed, and recovery-oriented approaches to service delivery
Knowledge of social determinants of health and barriers impacting access to care, housing, transportation, food security, and benefits
Familiarity with referral management, intake coordination, and client engagement practices
Knowledge of confidentiality requirements, HIPAA regulations, and documentation standards
Understanding of care coordination workflows and multidisciplinary team collaboration
Familiarity with electronic health records (EHRs), referral tracking systems, and data management practices
Knowledge of community resources and provider networks across behavioral health, medical, housing, and social service systems
Strong organizational and time management skills with the ability to manage multiple referrals, deadlines, and competing priorities
Excellent interpersonal and customer service skills with the ability to engage individuals from diverse backgrounds
Strong verbal and written communication skills
Ability to conduct outreach and engagement in a professional, compassionate, and persistent manner
Ability to triage referrals and determine appropriate service pathways based on individual needs and eligibility criteria
Strong attention to detail and accuracy in data entry, documentation, and billing-related activities
Ability to navigate insurance portals, authorization systems, and electronic health record platforms
Problem-solving and critical thinking skills with the ability to address barriers to care and resolve administrative issues
Ability to work collaboratively within a centralized intake team and across multidisciplinary programs
Ability to maintain confidentiality and exercise sound judgment in handling sensitive information
Proficiency in Microsoft Office Suite and other database or care management systems
Ability to analyze and track referral, authorization, and billing information for reporting and follow-up purposes
Ability to work independently while maintaining strong communication and coordination with team members
Cultural competency and ability to work effectively with individuals experiencing behavioral health, substance use, housing instability, and complex social needs.
Minimum of 2 years of experience in healthcare, behavioral health, care coordination, intake, insurance navigation, billing support, or related human services setting.
Experience working with MassHealth, Medicare, One Care, or other public insurance programs.
Experience with prior authorizations, utilization management, or healthcare billing processes.
Ability to obtain and maintain Certified Application Counselor (CAC) certification.
Strong organizational skills with the ability to manage multiple priorities and timelines.
Excellent communication, customer service, and engagement skills.
Proficiency with electronic health records, Microsoft Office, and data tracking systems.
Ability to work collaboratively across multidisciplinary teams.
Certified Application Counselor Certificate
CPR within 2 weeks of hire
First Aid within 2 weeks of hire
New Employee Training (NET)

Nice To Haves

Understanding of Certified Application Counselor (CAC) roles, responsibilities, and health insurance enrollment processes preferred
Associate’s or Bachelor’s degree preferred.

Responsibilities

Manages incoming referrals for Integrated Care Division programs through centralized referral systems and workflows.
Reviews referrals for completeness, eligibility, and appropriateness of services.
Coordinates intake and engagement activities to ensure timely connection to services.
Conducts outreach to referred individuals, providers, hospitals, community agencies, and other referral sources.
Maintains ongoing communication with referral sources regarding referral status and disposition.
Supports screening and triage processes to determine the most appropriate level of care or service.
Facilitates referrals to external providers and community resources when individuals’ needs fall outside of the agency’s scope of services.
Engages referred individuals using person-centered and trauma-informed approaches.
Assists individuals with navigating services, scheduling initial appointments, and overcoming barriers to engagement.
Documents outreach attempts, engagement activities, and referral outcomes in electronic health record and tracking systems.
Collaborates with program staff and leadership to support continuity of care and successful transitions into services.
Verifies insurance eligibility and benefits, including MassHealth, Medicare, One Care, and other coverage types.
Obtains and tracks prior authorizations and reauthorizations for assigned programs and services.
Monitors authorization timelines and ensure continuation requests are submitted timely to avoid service disruptions.
Supports billing readiness by ensuring required documentation and authorizations are in place.
Collaborates with billing, finance, and clinical teams to resolve authorization or claims-related issues.
Maintains Certified Application Counselor (CAC) certification requirements.
Supports individuals with health insurance applications, renewals, troubleshooting, and navigation of MassHealth, Medicare, and other public insurance programs.
Provides education and assistance related to insurance eligibility, benefits, and enrollment processes.
Collaborates with internal teams to support the agency’s centralized health insurance counseling function.
Maintains accurate and timely documentation in all required systems.
Tracks referral, engagement, and authorization metrics as requested.
Participates in team meetings, trainings, and quality improvement initiatives.
Maintains knowledge of program eligibility requirements, payer requirements, and community resources.
Ensures compliance with agency policies, confidentiality standards, and regulatory requirements.
Performs related duties as assigned.