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Insurance Specialist
2 months ago
Sun River Health provides the highest quality of comprehensive primary, preventative and behavioral health services to all who seek it, regardless of insurance status and ability to pay, especially for the underserved and vulnerable. Sun River Health is a Federally Qualified, Non-Profit Health Center serving communities in Suffolk, Rockland, Orange, Dutchess, Ulster, Sullivan, Columbia and Westchester County. Sun River Health is currently seeking a full-time Insurance Specialist to join our team in Staten Island, NY.
The Insurance Specialist coordinates insurance benefits for patients including but not limited to enrollment/disenrollment processes, restrictions, visit authorizations, and payments for services. Performs clerical duties, acts as receptionist, coordinates patient appointments, and communicates with all disciplines.
Essential Job Duties of Insurance Specialist:
• Adheres to Front Desk Protocol for patient flow (1. Reception, 2. Registration, 3. Discharge and follow up appointments).
• Point person for patients who are designated as self-pay, providing information on services and cost of care.
• Coordinates discharge process when indicated - schedules, all f/u appointments, prior approvals, etc.
• Verify insurance coverage and obtain necessary authorization for medical/dental/behavioral health visits.
• Coordinates reception/front office operations duties - Greet and register all patients as they arrive, perform insurance verification/MUT preparation, schedule appointments, answer calls, take messages and other similar clerical tasks when indicated.
• Serves as a resource to registrar staff for source of insurance information and direction.
• Assist with the enrollment process in Medicaid Managed Care plans
• Conforms to policies and regulations governing patient rights and confidentiality of information
• Serves as a resource to patients regarding insurance enrollments, restrictions, deductibles and co-payment information and collection.
• Handles complex insurance issues as necessary including but not limited to restrictions, verifications, and visit authorizations.
Minimum Education Requirement : High School diploma/ GED
Work Related Experience : 2-4 years
Preferred Specialized Skills & Knowledge: Bilingual in both English and Spanish (orally and written)
Job Type: Full-time
Pay: $17.25 - $19.00 per hour
Responsibilities
Relation to Mission
The mission of Sun River Health is to increase access to comprehensive primary and preventive health care and to improve the health status of our community, especially for the underserved and vulnerable.
Equal Employment Opportunity
Sun River Health provides equal employment opportunities to all qualified individuals without regard to race, creed, color, religion, national origin, age, sex, marital status, sexual preference, or non-disqualifying physical or mental handicap or disability in each aspect of the human resources function.
Americans with Disabilities Act
Applicants as well as employees who are or become disabled must be able to perform the essential job functions either unaided or with reasonable accommodation. The organization shall determine reasonable accommodation on a case-by-case basis in accordance with applicable law.
Job Responsibilities
The following statements reflect the general duties, responsibilities and competencies considered necessary to perform the essential functions of the job and should not be considered as a detailed description of all the work requirements of the position. Sun River Health may change the specific job duties with or without prior notice based on the needs of the organization.
About Us
Sun River Health is a network of 43 Federally Qualified Health Centers (FQHCs) providing primary, dental, pediatric, OB-GYN, and behavioral health care to over 245,000 patients annually. With a dedicated staff of 2,000 doctors, nurses, and health care professionals, we pride ourselves on delivering high-quality, affordable care to those who need it most. Sun River Health started in 1975 when four African American mothers spearheaded efforts to open our first health center in Peekskill, New York to deliver accessible, high-quality, affordable services to patients in need - no matter their race, religion, income, or insurance status. Today, after 45 years of service, Sun River Health is still delivering on that promise to communities across the Hudson Valley, New York City, and Long Island.
