Benefit Eligibility Specialist Job – , 765017

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 Join our team at Acorn Health, an exciting and expanding organization with programs in FL, IL, MD, MI, PA, TN and VA. We are seeking a Full Time Benefit Eligibility Specialist to join our multidisciplinary team!. We work together to deliver exceptional clinical services, tailored to the lives of the children and families we serve.


About Acorn Health

Acorn Health is an expanding family of ABA companies; we deliver the highest quality of intensive, behavior-based treatment for children with autism spectrum and related disorders. We are a partnership of behavior analytic professionals who develop, apply, and share the latest advances in the science of applied behavior analysis (ABA) to improve the lives of the families we serve. And while each of our partner companies is unique, we all share important core values.


AUTHENTICITY: We present our true, selves. Everyone hungers for genuine connections.

ACCOUNTABILITY: We keep our promises and can be trusted with the life and future of a child.

TEAMWORK: The best outcomes are produced by people who collaborate with enthusiasm.

GROWTH: We know the needs of children and their families are unique and ever-changing.

HUSTLE: In autism care and treatment, time is always of the essence. We do things now.


The Benefit Eligibility Specialist plays a key role between incoming and existing clients, beginning critical therapeutic services, and successful claims submissions. Facilitate the eligibility process and ensure a timely participation status for contracted payers. This

position will coordinate with the interdisciplinary team and ensure payer compliance across all platforms for the insurance benefit process in a timely manner through communication with admissions, client experience, authorizations team, and operations.

  

Job Duties and Responsibilities:

  • Primary responsibility is to conduct phone calls with individual insurance benefit representatives or utilize insurance portal access to determine coverage for ABA therapies or related services.
  • Advocate in support of the client’s interests by identifying potential issues with the results of verification inquiries.
  • Escalating any potential network issues and collaborating with the credentialing and contracting team to assure services are in network.
  • Confirming all relevant insurance and diagnostic details to prevent any negative impact related to compliance or regulatory requirements.
  • Maintain timely communication with external providers regarding eligibility, supporting documentation, and credentialing and/or related provider issues
  • Maintenance of all payor information on file for all clients across the organization
  • Documents and keeps records of eligibility
  • Ability to clearly explain benefit information to families
  • Keep abreast of insurance updates and/or changes in state mandates
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partner: paylocity

jobid: 765017

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