Intake & Insurance Verification Specialist

Oakland Family Services•Pontiac, MI

1d•Hybrid

About The Position

The Intake and Insurance Verification Specialist is responsible for acquiring and maintaining current knowledge of Agency programs, including admission and eligibility criteria; for interviewing clients and potential clients to facilitate their choice of appropriate services based on expressed need, for the admission and maintenance of all Oakland Family Services’ Day One clients by preparing case records, scheduling client appointments, monitoring insurances and fees, and providing support services to the professional operations of the Agency. The Intake and Insurance Verification Specialist works cooperatively as a team with other staff and reports to the assigned Supervisor of Clerical Operations.

Requirements

Minimum high school diploma or equivalent. Associate degree preferred.
Demonstrated skill in office procedures, data entry, and human services.
Understanding of HIPAA, patient rights, medical record processing and communication – desired.
Minimum two years of insurance knowledge/verification experience required.
Well-developed verbal and written communication skills.
Must be detail oriented.
Ability to establish and maintain good relationships with persons internal and external to the agency.
Ability to accept supervisory direction and to work independently on assigned tasks.
Selected candidates for this position must possess a sensitivity to the diversity of the Agency’s service population and candidate/employee population including (but not limited to) differences of culture, race, religion, gender, sexual orientation, and socioeconomic characteristics.
Special abilities and skills necessary to perform the required tasks and that best meet the needs of the agency also will be considered. There may be some standards above that may be waived when compensating specifications or circumstances exist.

Nice To Haves

Associate degree preferred.
Understanding of HIPAA, patient rights, medical record processing and communication – desired.

Responsibilities

Accepts incoming calls or emails from clients requesting first time appointments for Day One treatment at all sites.
Utilizes CareLogic, DocuSign and any other internal technology needed to complete responsibilities.
Obtains all demographic and insurance information for the client and/or guarantor; correctly sets-up and maintains demographics, insurance, copays, deductibles, co-insurance, client-responsibility information in all systems ensuring that all information fields are completed as required.
Utilizes various insurance information verification websites (i.e. Availity, Health Plan Benefits , Web-Denis, CSNAP, etc.) to obtain information about the client’s insurance benefits/coverage.
Determines appropriate self-pay fees for income eligible individuals seeking mental health treatment without insurance coverage, and/or initiates process of collecting documentations for OCHN self-pay underinsured information for SUD clients with high commercial deductibles or copays who identify this need at the time of initial contact.
Notifies client of benefit coverage including co-pays, co-insurance and deductible information.
Schedules client with appropriately licensed clinician based on population served (i.e., young children, geriatric clients, couples, etc.), insurance type and clinician availability.
Sends intake paperwork that matches with their payer and program through DocuSign or Carelogic Client Portal.
Completes entire process of taking the call, obtaining information, verifying insurance benefits and scheduling the intake all at the same time, as appropriate.
With assistance, reverifies all commercial insurances annually.
Actively maintains and works to engage clients on the Incomplete Point of Entry (IPOE) log in CareLogic.
Partners with the Day One team to identify and eliminate barriers to service.
Verifies commercial insurance for clients in the Specialized Services for Youth program, as needed, and enters insurance information into ODIN.
Assists and/or provides coverage for all clerical duties including but not limited to; uploading documents into Carelogic, answering phones, checking in clients/collecting copays, and all other assigned duties.
Responsible for incorporating principles of diversity, equity and inclusion in work processes and in job functions. Responsible for promoting a feeling of welcoming, belonging, and acceptance to all clients and staff.
Other duties as assigned.

Benefits

Competitive compensation.
Comprehensive medical, dental, prescription, and vision coverage.
Flexible Spending Accounts and HSA options.
Retirement plan with a company match.
Long-term disability insurance.
Voluntary short-term disability.
Life insurance and AD&D.
Malpractice insurance.
Paid time off benefits, including generous vacation, sick, personal, and bereavement days.
Twelve (12) paid holidays, including a floating holiday of your choice!
Annual pay increases, as approved.
Employee assistance program for you and immediate family.
Network of support for your health & well-being.
Verizon cellular plan discount.
Mileage reimbursement at the IRS rate.
Loan forgiveness programs.
Commitment to diversity, equity, inclusion, and belonging.
Family friendly practices and support.
Flexible work schedules, as appropriate.
Hybrid and virtual work options, as appropriate.
Highly robust and comprehensive onboarding and training program.
Paid professional development.
Free online trainings that count toward continuing education credits.
Employee assistance programs.
“Dress for Your Day” approach to dress code.
Financial literacy education and workshops.
Collaborative annual performance appraisals.
“Dollars for a Difference” program for clients and staff in need.