Job details
Job type full-time
Full job description
Overview: connections health solutions is hiring a member benefit specialist who will verify member’s health insurance benefits and eligibility and update member’s insurance information in emrThe member benefit specialist will notify insurance companies of admissions and assist in obtain prior authorization, as requiredAssess and determine if a member qualifies for ahcccs and/or federal marketplace insurance coverage and assist the member in completing the applications responsibilities:
Ensures the accuracy of patient demographic and insurance information, updating as necessary.
Collects, verifies and communicates necessary information with member’s insurance carrier.
Assists members with steps to apply for insurance coverage such ahcccs and marketplace.
Meets and maintains tracking requirements, forms and reports including those set forth by rbhaIncluding any specific compliance submissions that includes notification to member’s insurance company of admission.
Obtains prior authorization for services as required by the insurance company.
Researches and resolves enrollment discrepancies and assists with obtaining missing data to support eligibility determinations.
Documents financial screening activities in the medical record.
Completes intake (834) for all crisis services to rbha
Performs initial determination of ahcccs eligibility for uninsured adults and children
Completes applications for eligible individuals using health-e arizona plus web site.
Tracks ahcccs and/or marketplace applications to ensure completeness and acceptanceProvides follow-up call with patients to assist with any pending items set forth by ahcccs.
Qualifications: minimum qualifications:
High school diploma or equivalent.
At least 2 years of behavioral health or relevant experience.
At least 1 year of medical insurance verification experience.
Knowledge of third party, ahcccs,and/or marketplace insurance plans.
Preferred qualifications:
Current hea plus assister qualifications
