Insurance Specialist - Behavioral Health

Job Description

Sun River Health provides the highest quality of comprehensive primary, preventative and behavioral health services to all who seek it, regardless of insurance status and ability to pay, especially for the underserved and vulnerable. Sun River Health is a Federally Qualified, Non-Profit Health Center serving communities in Suffolk, Rockland, Orange, Duchess, Ulster, Sullivan, Columbia and Westchester County. Sun River Health is seeking a full-time Insurance Specialist to support the HUB site in the Bronx, NY.

Position Summary:

The Insurance Specialist coordinates insurance benefits for patients including but not limited to enrollment/disenrollment processes, restrictions, visit authorizations, and payments for services. Performs clerical duties, acts as receptionist, coordinates patient appointments, and communicates with all disciplines.

Job Type: Full-Time

Pay Range: $21.00 to $24.35 per hour

Essential Duties and Responsibilities

• Coordinates reception/front office operations duties - Greet and register all patients as they arrive, perform insurance verification/MUT preparation, schedule appointments, answer calls, take messages and other similar clerical tasks when indicated
• Verify insurance coverage and obtain necessary authorization for medical/dental/behavioral health visits
• Adheres to Front Desk Protocol for patient flow (1. Reception, 2. Registration, 3. Discharge and follow up appointments)
• Coordinates discharge process when indicated - schedules, all f/u appointments, prior approvals, etc
• Handles complex insurance issues as necessary including but not limited to restrictions, verifications, and visit authorizations
• Point person for patients who are designated as self-pay, providing information on services and cost of care
• Serves as a resource to patients regarding insurance enrollments, restrictions, deductibles and co-payment information and collection
• Serves as a resource to registrar staff for source of insurance information and direction
• Assist with the enrollment process in Medicaid Managed Care plans
• Conforms to policies and regulations governing patient rights and confidentiality of information

Requirements:

• Minimum Education Requirement: High school diploma/ GED
• Minimum Work-Related Experience: 2-4 years
• Preferred Skills: Bilingual in Spanish (Oral and written)

About Sun River Health

Sun River Health has a rich history of providing quality, affordable health care to communities in need. Founded in the early 1970s by four African American women in Peekskill, New York, the organization was established to address the lack of accessible health services in their community. With the help of a small federal grant, the first Sun River Health site opened its doors in 1975. Over the years, Sun River Health has grown into a comprehensive Federally Qualified Health Center (FQHC) system with over 45 locations, serving more than 250,000 patients across the Hudson Valley, New York City and Long Island. Our exceptional primary care practitioners, specialists and support staff are dedicated to delivering high-quality care to all individuals, regardless of their ability to pay. In December 2018, Sun River Health expanded its reach by merging with Brightpoint Health, an FQHC network offering integrated medical, behavioral and social support services in New York City. This merger allowed us to enhance our services and continue our mission under the unified name of Sun River Health.

Our Culture

At Sun River Health, we believe in fostering a culture of wellness, inclusivity and recognition. Our Workforce Wellness Program promotes staff wellness through ongoing challenges and activities, encouraging participation and rewarding engagement. We celebrate our staff's dedication and person-centered spirit through the Planetree Recognition Awards, which honor innovation, leadership and community spirit. We are committed to creating a supportive and collaborative work environment where all team members can thrive. Our values of respect, integrity and excellence guide our interactions with patients and colleagues alike, ensuring that everyone receives the care and support they deserve.

Benefits

At Sun River Health, we are committed to building a personal relationship with our team and supporting you in every way we can. We offer competitive compensation and a comprehensive benefits package for you and your family, including:

• Medical, Dental and Vision Insurance: Comprehensive health coverage to ensure you and your family stay healthy.
• Life and Disability Coverage: Financial protection for you and your loved ones in case of unforeseen circumstances.
• Retirement Savings Plan: Plan for your future with our retirement savings options.
• Commuter and Transit Benefits: Assistance with your daily commute to make your journey to work easier.
• Employee Assistance Program (EAP): Access to confidential support and resources for personal and work-related issues.
• Employee Discount Program: Enjoy discounts on various products and services as a valued member of our team.

Professional Development, Education and Loan Assistance Benefit Programs

• Sun River Health is committed in fostering continued growth, education, and professional advancement across its organization. Through a range of development opportunities and loan repayment programs employees are supported at every stage of their careers.
• Eligible employees may have the opportunity to participate in federal and state loan repayment or loan forgiveness programs, including those administered by the Health Resources and Services Administration (HRSA) and the National Health Service Corps (NHSC) with support provided throughout the application process.
• In addition, Sun River Health offers a Tuition Reimbursement Program for eligible employees that supports job-related coursework completed through accredited institutions, helping employees continue building their skills and advancing their careers.

Why Join Sun River Health?

• Mission-Driven Work: Be part of a proud network of care that offers high-quality health and social support services to communities in need.
• Professional Growth: We provide opportunities for career advancement and professional development.
• Supportive Environment: Our culture promotes wellness, inclusivity, and recognition, ensuring a supportive and collaborative work environment.
• Community Impact: Make a difference in the lives of individuals and families by providing quality, affordable health care.

Join us at Sun River Health and be part of an award-winning network of care that has been serving our communities since 1975. We are always looking for skilled and dedicated professionals to join our team and help us continue our mission of providing quality health care to all.

Responsibilities

Relation to Mission
The mission of Sun River Health is to increase access to comprehensive primary and preventive health care and to improve the health status of our community, especially for the underserved and vulnerable.

Equal Employment Opportunity
Sun River Health provides equal employment opportunities to all qualified individuals without regard to race, creed, color, religion, national origin, age, sex, marital status, sexual preference, or non-disqualifying physical or mental handicap or disability in each aspect of the human resources function.

Americans with Disabilities Act
Applicants as well as employees who are or become disabled must be able to perform the essential job functions either unaided or with reasonable accommodation. The organization shall determine reasonable accommodation on a case-by-case basis in accordance with applicable law.

Job Responsibilities
The following statements reflect the general duties, responsibilities and competencies considered necessary to perform the essential functions of the job and should not be considered as a detailed description of all the work requirements of the position. Sun River Health may change the specific job duties with or without prior notice based on the needs of the organization.