INSURANCE VERIFICATION SPECIALIST

Job Description

Job Description

Established in 1926, Family Service League is a social services agency transforming lives and communities through mental health, addiction, housing, and essential human services with more than 60 social service programs in over 20 locations.

SCHEDULE:

This is a part-time position with flexible hours and the majority of work being completed remotely. Work will be completed within a Monday- Friday schedule. 

**Candidate must be local to Long Island with the ability to travel to an office for training and other occasions as needed.  

SUMMARY:

Family Service League is seeking a part-time Insurance and Verification Specialist to support the Children and Family Treatment and Support Services (CFTSS) program by ensuring that clients have received required prior authorizations from Managed Care Organizations. This role is also responsible for verifying that all enrolled clients maintain active and valid insurance coverage, including Medicaid, Child Health Plus, and Family Health Plus.

RESPONSIBILITIES:

• The Insurance Verification Specialist will submit insurance prior authorization requests and all required documentation in a timely manner.
• Coordinate with various Medicaid Managed Care Organizations regarding authorization requests.
• Attend all webinars for and stay current on all requirements for authorizations for each Managed Care Organization (MCO)
• Maintain and update authorization tracking tools so the billing department and management can monitor authorization status.
• Notify the billing vendor of authorizations received.
• The Insurance Verification Specialist will verify insurance eligibility and coverage status for clients, as needed.
• Communicate with CFTSS staff to ensure all required documentation for authorizations is obtained.
• Navigate insurance verification systems, including ePACES and Availity Essentials.
• All other duties as assigned.

  QUALIFICATIONS:

• High School diploma or equivalent required.
• One year of related experience working in medical billing, coding or authorizations.
• Proficient computer skills, including Microsoft Office, especially Excel required; familiarity with medical software, and insurance websites, and advanced Excel skills. 
• Ability to work both independently and as part of a team in a fast paced environment.
• Excellent organizational, and verbal and written communication skills.
• Strong initiative, attention to detail and the ability to multi-task are required.

PHYSICAL REQUIREMENTS:

Prolonged periods of sitting and working at a computer.