Insurance Agency Professional

Job Description THIS IS A HYBRID ROLE BASED IN FARMINGTON HILLS, MI - MUST BE ABLE TO DRIVE INTO THE OFFICE AS REQUESTED.

PAY RATE $17.00 - $20.00/hr plus bonus

Position Summary The Authorization and Insurance Specialist position is responsible for collecting client demographic and insurance information, processing that information for collections and reimbursement, and the timely and successful submission of pre-authorizations (pre-auths) of services to insurance payors. This directly correlates to mitigating and reducing bad debt for Centria Autism by initiating the continuous review and follow-up of the eligibility and pre-authorization for Diagnostic Evaluations, Initial Assessments, and Ongoing Treatment (if applicable by payor/market). The Authorization and Insurance Team should identify and understand all payor rules for the proper adjudication of the pre-auths and verification of ABA Therapy insurance coverage and benefits for our client families when needed. They are responsible for managing the overall pre-auth process, which includes but is not limited to following up with the Operations/Clinical Teams and coordinating all applicable documentation and action needed to complete the securing of an approved authorization.

The Authorization and Insurance Team provides superior customer service and support to the Operations Teams and all other Revenue Cycle Management/Centria Autism teams that provide services and support to our client families. Work collaboratively with the Intake Team to verify insurance coverage and benefit details for ABA Therapy.

• Request and track commercial and Medicaid authorizations.
• Maintain active insurance coverage(s) for all clients.
• Ability to communicate effectively, both oral and written, with internal staff, clients/guardians, and payors/insurance companies.
• Ensure strict confidentiality of client records according to policy and procedures; Make administrative and procedural decisions and judgments on confidential issues.
• Knowledge of computer data entry systems, protocols, and procedures.
• Answer and direct phone calls to appropriate parties and handle time-sensitive issues from internal staff.

QualificationsEducation/Licenses High School diploma or equivalent, minimum requirement

Work Experience

• 1—2 years of call center or customer service experience
• Minimum typing proficiency of 55 words per minute with errorless typing
• Knowledge of in-state and out-of-state commercial insurance plans, preferred
• Equipment and Technology Requirements

Basic computer skills

Proficiency in Microsoft Suite

Ability to use computers and computer/software programs

Proficient in Microsoft Office Suite, especially spreadsheet programs;

Superb customer service and phone etiquette skills;

Ability to build rapport with team members, explain complicated information in an approachable and easily understood manner, effectively handle challenging phone conversations, and represent the Centria brand;

Excellent interpersonal, customer relationship, and listening skills;

Demonstrated strong work ethic with attention to detail, accuracy, and quality;

Centria's office hours are Monday through Friday from 8:30 AM – 6:00 PM.

Additional time or occasional shifts in schedule may be required to complete the above work or meet company objectives.

This role may require close visual acuity on computer screens or monitors and the ability to analyze data and figures on a screen.

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, Veteran status, or disability status.