Nystrom & Associates, Ltd. is a team of mental health professionals that specialize in psychiatric evaluations, clinical social work, and family therapy. We are committed to helping patients in our community who are experiencing personal, emotional, marriage, family or psychological problems. Founded in 1991, we offer an intensive outpatient chemical dependency program, psychological testing, and behavioral health and medication management services.
We are currently seeking a full-time Insurance Specialist to join our West Des Moines Business office. In this role you will execute the fast-paced task of verifying insurance eligibility for patients. This role ensures all insurance benefits are verified, provider eligibility is verified per insurance carrier, and authorization requirements are received in a timely manner to ensure optimal reimbursements.
The job duties of our Insurance Specialist focuses on verifying mental health or chemical dependency insurance eligibility, verifying updated insurance information within 24 hours of receipt, obtaining initial authorizations/referrals as needed, and any other duties as assigned by management. Other duties include the following:
Job Duties:
- Verification of Insurance Eligibility/Benefits for OP, ARMHS & CTSS services
-
Initiate necessary Authorizations/Referrals as needed
- Completing the auth process as applicable
- Appointments are flagged accordingly
- Completing the auth process as applicable
- Field/Resolve provider/clinic inquiries via Email or Task
- Inquiries are followed up within 24 hours of creation
- Attend and participate in biweekly staff meetings and any other meetings and/or training sessions as indicated.
- All other duties as assigned by Management.
Expectations:
- Extreme attention to detail while multitasking
- Extreme ability to organize and track large amounts of data
- Verification Benchmarks are met on a time frame as established by Management.
- Flexibility
-
New Patient, Referral, Termed , CD Eval, CD Orientation, CDDA, CBDA & CBADA appointments are verified within 2 business days of being scheduled
- Are marked with GREEN checkmark to confirm active coverage based on Insurance coverage, Provider exceptions, and Authorization requirements
- Policies are set up correctly based on NAL approved Insurance Verification Process
- Follow-up appointments are verified by the IVerify system
- Any appointments found inactive are followed up on within 1 business day of the inactive verification and communicated to clinical staff.
- Manual reverifications of insurance not verified by the automated system are done as needed.
- Initial Authorization orders are entered into Allscripts EEHR according to authorization policy
- Initial Authorizations are set up in Allscripts PM according to authorization policy
- Patient Accounts are noted appropriately in EEHR and PM
- Recognize/report trends and patterns with providers & clinics
- Recognize/report trends and patterns with insurance companies
- Back up Authorization Specialist with Authorization requests & approvals
- Open communication with Supervisor & Lead
- Arrive and leave on time according to assigned schedule
- Adhere to attendance policies
Qualifications:
- Experience working with Excel preferred
- Ability to work on dual monitors
- Ability to work in multiple software programs
- Minimum of two years working in health care facilities preferred, particularly with insurance verification and knowledge of prior authorization process.
- Familiarity with insurance company guidelines and HIPAA regulations.
Hours:
- Monday - Friday, general day time hours- 8am-4:30pm OR -7am-3:30pm
Benefits:
Nystrom & Associates, Ltd. prides itself on the benefits and compensation offered to staff, including:
- Medical & Dental insurance
- Opportunities for professional growth and career advancement
- Health Savings Account (HSA)
- Flexible Spending Account (FSA) for applicable medical and dependent care expenses
- Paid Time Off (PTO)
- Paid Holidays
- 401(K) Retirement Plan with a generous employer matching program
- Supplemental insurances, such as short term disability, cancer insurance, and accident insurance
- Experience working with Excel preferred
- Ability to work on dual monitors
- Ability to work in multiple software programs
- Minimum of two years working in health care facilities preferred, particularly with insurance verification and knowledge of prior authorization process.
- Familiarity with insurance company guidelines and HIPAA regulations.
Nystrom & Associates, Ltd. is a team of mental health professionals that specialize in psychiatric evaluations, clinical social work, and family therapy. We are committed to helping patients in our community who are experiencing personal, emotional, marriage, family or psychological problems. Founded in 1991, we offer an intensive outpatient chemical dependency program, psychological testing, and behavioral health and medication management services.
We are currently seeking a full-time Insurance Specialist to join our West Des Moines Business office. In this role you will execute the fast-paced task of verifying insurance eligibility for patients. This role ensures all insurance benefits are verified, provider eligibility is verified per insurance carrier, and authorization requirements are received in a timely manner to ensure optimal reimbursements.
The job duties of our Insurance Specialist focuses on verifying mental health or chemical dependency insurance eligibility, verifying updated insurance information within 24 hours of receipt, obtaining initial authorizations/referrals as needed, and any other duties as assigned by management. Other duties include the following:
Job Duties:
- Verification of Insurance Eligibility/Benefits for OP, ARMHS & CTSS services
-
Initiate necessary Authorizations/Referrals as needed
- Completing the auth process as applicable
- Appointments are flagged accordingly
- Completing the auth process as applicable
- Field/Resolve provider/clinic inquiries via Email or Task
- Inquiries are followed up within 24 hours of creation
- Attend and participate in biweekly staff meetings and any other meetings and/or training sessions as indicated.
- All other duties as assigned by Management.
Expectations:
- Extreme attention to detail while multitasking
- Extreme ability to organize and track large amounts of data
- Verification Benchmarks are met on a time frame as established by Management.
- Flexibility
-
New Patient, Referral, Termed , CD Eval, CD Orientation, CDDA, CBDA & CBADA appointments are verified within 2 business days of being scheduled
- Are marked with GREEN checkmark to confirm active coverage based on Insurance coverage, Provider exceptions, and Authorization requirements
- Policies are set up correctly based on NAL approved Insurance Verification Process
- Follow-up appointments are verified by the IVerify system
- Any appointments found inactive are followed up on within 1 business day of the inactive verification and communicated to clinical staff.
- Manual reverifications of insurance not verified by the automated system are done as needed.
- Initial Authorization orders are entered into Allscripts EEHR according to authorization policy
- Initial Authorizations are set up in Allscripts PM according to authorization policy
- Patient Accounts are noted appropriately in EEHR and PM
- Recognize/report trends and patterns with providers & clinics
- Recognize/report trends and patterns with insurance companies
- Back up Authorization Specialist with Authorization requests & approvals
- Open communication with Supervisor & Lead
- Arrive and leave on time according to assigned schedule
- Adhere to attendance policies
Qualifications:
- Experience working with Excel preferred
- Ability to work on dual monitors
- Ability to work in multiple software programs
- Minimum of two years working in health care facilities preferred, particularly with insurance verification and knowledge of prior authorization process.
- Familiarity with insurance company guidelines and HIPAA regulations.
Hours:
- Monday - Friday, general day time hours- 8am-4:30pm OR -7am-3:30pm
Benefits:
Nystrom & Associates, Ltd. prides itself on the benefits and compensation offered to staff, including:
- Medical & Dental insurance
- Opportunities for professional growth and career advancement
- Health Savings Account (HSA)
- Flexible Spending Account (FSA) for applicable medical and dependent care expenses
- Paid Time Off (PTO)
- Paid Holidays
- 401(K) Retirement Plan with a generous employer matching program
- Supplemental insurances, such as short term disability, cancer insurance, and accident insurance