For over 30 years, New Season Treatment Centers have been a leading national health care service provider of outpatient treatment centers that specialize in providing safe, quality and best in class care for individuals living with Opioid Use Disorder ("OUD").
Operating in over 70 treatment centers in multiple states, our team members are engaged in medication-assisted treatment, counseling, support, and care management of individuals living with OUD. We treat the whole person and, in so doing, address the underlying causes of OUD in an effort to provide a continuum of care that not only addresses treatment needs but supports the patient on their journey to recovery.
This position is responsible for verifying patient insurance benefits, obtaining the appropriate authorization, referrals, and care coordination from the insurance companies and third-party payers. This also includes providing detailed and timely communication to both payers and clinical partners in order to facilitate compliance of benefits and care.
➢ Verifies insurance eligibility and benefit levels to ensure adequate coverage for identified services.
➢ Responsible for pre-certification, authorization, and referral requirements for services.
➢ Communicates with patients, clinical partners, financial counselors, and others as necessary to facilitate the authorization process.
➢ Facilitate submission of clean claims and reduction in payer denials by adhering to both organizational and departmental policy and procedures.
➢ Ensures timely and accurate insurance authorizations are in place prior to services being rendered.
➢ Prioritize workload to ensure the most urgent cases are handled in a timely manner.
➢ Keep open lines of communication with the Clinic Operation Team to ensure individualized goals are met.
➢ Adheres to the service policy and principles of CMG/ New Seasons.
- High School Diploma or GED.
- Understanding of the various types of insurances.
- Knowledge of computer and internet applications and data management as well as an understanding of reporting requirements.
- Proficiency with numbers.
- Data entry experience.
- Experience working with Zirmed/Waystar program is a plus.
- Computer skills, and proficiency with Microsoft Office and Google.
- Excellent internal & external customer service and communication skills.
- Understanding of insurance and insurance related coding to support claim processing.
- Understanding of government payers including Share of Cost.
- This position requires a minimum of 1 year of experience in insurance verification and pre-authorization.
- Prior experience in a business office position.
- Strong customer service background preferred.
Skill and Ability:
- Ability to work with both technical and administrative personnel.
- Strong organizational skills with a keen ability to prioritize and multitask.
- Ability to adhere to and meet deadlines.
- Experience in handling sensitive, confidential information.
- Excellent communicator (oral and written) including the desire to ask questions and learn from co-workers.
- Strong Excel and other MS Office product skills.
- Strong administrative and data entry skills.
- Ability to raise issues proactively and in a timely manner.
- Excellent Customer service skills.
- Time Management
- Communication (Oral)
- Problem Solving
- Strategic Planning/Thinking
40 hoursCMG Corporate