Insurance Verification Specialist

Insurance Verification Specialist

At Many Rivers Whole Health, we partner with people and communities to serve the whole person: body, mind, and spirit. Through compassionate, recovery-oriented behavioral health services, we help individuals achieve wellness while strengthening the communities we serve. Our team is dedicated to empowering individuals and creating opportunities for recovery, growth, and independence.

This is more than an administrative role. It's an opportunity to help individuals navigate the often-complex world of healthcare coverage while making sure they have accurate information about their insurance, eligibility, and financial responsibilities.

As our Insurance Verification Specialist, you'll have the opportunity to:

• Help clients understand and navigate their insurance coverage, eligibility, and billing information
• Verify insurance coverage and help ensure client information is accurate and up to date
• Assist clients with insurance re-enrollment, payment plans, and sliding fee options when appropriate
• Work closely with billing, clinical, and administrative teams to support smooth access to services
• Research coverage concerns and help determine next steps when services may not be covered
• Support accurate provider credentialing and insurance participation information
• Develop valuable knowledge of Medicaid, Medicare, commercial insurance, and healthcare billing processes
• Make a meaningful difference by helping remove administrative and financial barriers to behavioral healthcare

Excellent benefits package, including:

• 401(k) with employer matching
• Medical Insurance
• Dental Insurance
• Vision Insurance
• Flexible Spending Account (FSA)
• Health Savings Account (HSA)
• Paid Time Off & Paid Birthday Off

Wage: $23.51 per hour

As the Insurance Verification Specialist, you will play an important role in helping clients navigate insurance coverage, eligibility, and billing while supporting accurate and efficient service delivery. You'll work with clients, insurance payers, providers, and internal teams to ensure information is current, complete, and communicated appropriately.

Your responsibilities will include:

• Meeting with clients as needed to verify current insurance coverage and assisting with insurance re-enrollment
• Explaining agency billing procedures and helping clients understand information related to their accounts
• Assisting clients with payment plans and sliding fee scales, when appropriate
• Reviewing, verifying, and maintaining accurate client insurance, eligibility, and billing information
• Researching services that may not be covered by insurance and assisting with appropriate next steps
• Verifying CCBHC eligibility requirements
• Reviewing client applications to ensure information is accurate and complete
• Ensuring clients are appropriately established with the correct providers and services
• Entering and maintaining information within the electronic health record (EHR) and client records
• Communicating insurance or account changes that may impact billing to Billing Specialists
• Verifying and monitoring provider credentialing and participation with applicable insurance plans
• Maintaining accurate information regarding provider participation with insurance payers
• Supporting insurance-related documentation, follow-up, and administrative processes
• Maintaining compliance with HIPAA, Medicaid, Medicare, commercial insurance requirements, and agency privacy and security standards

Required Qualifications:

• Bachelor's degree in Healthcare Administration, Benefits Administration, or a related field; OR
• Associate's degree plus two years of medical billing, insurance verification, or related experience; OR
• High school diploma/GED plus four years of relevant experience
• Experience with computers, Microsoft Word, and Microsoft Excel
• Excellent customer service, telephone, written communication, and proofreading skills
• Valid Montana driver's license, personal vehicle, and current vehicle insurance

Preferred Qualifications:

• Four years of healthcare customer service experience
• Experience with health insurance claims processing
• Experience working with an electronic health record (EHR)
• Knowledge of Medicaid, Medicare, commercial insurance, or other state and federal healthcare funding resources

All positions at Many Rivers Whole Health must pass Background and Motor Vehicle Record Checks.

You are organized, approachable, and detail-oriented, with a knack for making complicated information easier for others to understand. You recognize that insurance and billing questions can be confusing, and you approach each interaction with patience, professionalism, and a commitment to finding accurate information.

You:

• Communicate clearly and professionally with clients, coworkers, providers, and outside organizations
• Pay close attention to details and understand the importance of accurate insurance and billing information
• Enjoy researching information and working through questions to find the right answer
• Provide excellent customer service, even when situations are complex or sensitive
• Are comfortable balancing multiple priorities while keeping records accurate and up to date
• Exercise good judgment and know when an issue should be escalated for additional guidance
• Adapt well to changing insurance requirements, procedures, and client needs
• Work collaboratively and communicate important information to the right people
• Share our commitment to helping individuals access behavioral healthcare and understand the resources available to them

Many Rivers Whole Health partners with people and communities to serve the whole person, body, mind, and spirit, by providing expertise in wellness, mental health, and substance use disorders, addressing prevention and treatment through a recovery-based approach.