Insurance Coordinator

The Insurance Coordinator reports to the Insurance and Billing Manager and helps our ABA learner families navigate the complexities of eligibility, pre-authorizations, and all technical details of government sponsored (e.g., Medicaid) and private insurance plans. The position is responsible for maintaining learner and therapist documentation required by insurance carriers, submitting required documentation to obtain or renew authorizations to our third-party billing company, entering or reviewing billing, other insurance submissions to our third-party billing company, and providing guidance to learner families on plan eligibility requirements to resolve eligibility and billing issues. 

Insurance Coordinators often work independently. This requires the coordinator to be able to manage their workloads effectively to meet set deadlines. Strong computer skills are necessary for the input and maintenance of data, as well as for performing research regarding payor requirements. Interaction with other medical professionals, office personnel, and the public is standard.

Qualifications

• Bachelor’s degree preferred or equivalent work experience
• A minimum of 2 years of experience in insurance verifications, pre-authorizations, and billing in a clinic or behavioral health setting
• Experience resolving high level/sensitive customer service issues related to authorization, billing, and payment of behavioral health services

Expected Areas of Competence

• Analytical skills to receive, assemble and report on data records
• Extremely attentive to details
• Possess a high level of self-motivation and energy, and work with minimal supervision
• High organizational and time management skills
• Highly developed oral and written communication skills
• Fosters working relationships with leadership, clinical team, and other points of contact
• Ability to support multiple team members and projects simultaneously and prioritize in a fast-paced environment
• Proficiency in Excel as well as the Microsoft Office Suite which includes Word, Adobe, PowerPoint, Outlook, Teams
• Ability to work as part of a team with excellent interpersonal skills

Essential Duties and Responsibilities 

• Act as trusted adviser and serve as the main point of contact to learner families and clinicians on insurance-related inquiries by researching and resolving issues
• Help learner families with insurance-related billing inquiries and Explanation of Benefits (EOBs)
• Confirm status of learner’s deductible and accurately forecasts out-of-pocket expenses helping families arrange payment plans
• File appeals on authorization denials through third-party billing organization
• Handle learner pre-authorizations and documentation requirements
• Verify learner eligibility and benefits through online payor portals and through third-party billing organization
• Communicate and coordinate grant, hardship waivers, and Medicaid eligibility paperwork in a timely manner
• Review daily and weekly billing for accuracy and submit for claim submission within given time table
• Collaborate with clinical staff and family outreach to determine availability and openings at facilities
• Regularly communicates with internal and external parties via email and/or phone
• Support recurring internal and external audit of records
• Applies concept of continuous improvement to develop new skills during changing initiatives
• Confidentiality and trustworthiness, especially with regard to compliance with HIPAA, including Protected Health Information (PHI) and communications with patients
• Adhere to all company and department employment policies regarding security, compliance, HIPAA, and confidentiality

Company Overview
Lighthouse Autism Center is the leading Applied Behavior Analysis (ABA) therapy provider in Indiana, Michigan, and Illinois and expanding within those states and other states across the U.S. Since 2012, Lighthouse Autism Center has provided the highest quality, center-based ABA therapy to children with autism. At Lighthouse, children work on things like social skills, daily living skills, communication skills, and school-readiness skills. All children are overseen by Board Certified Behavior Analysts and programs are implemented by Registered Behavior Technicians. Lighthouse Autism Center also has full-time Speech-Language Pathologists on staff who provide co-treat and consultative services speech therapy services to children who attend the centers.