Member Financial Specialist

The member access function will ensure patients have a clear and consistent understanding of their financial standing, enable industry-leading responses to member financial needs, enable clean claims rates from the start of the member’s care, enforce clear guidelines on payment policies, and help ensure that care is affordable and accessible for each member.

You will also perpetuate the organization’s DNA by infusing a strong sense of mission, values, and team into all training, and by nurturing and developing our talent. 

• Work 1:1 with members prior to member registration and during ongoing treatment to address questions on eligibility, benefits, payment, and more.
• Educate members about benefits, member responsibility, payment options and financial assistance.
• Complete ongoing eligibility checks, prior authorizations, and solve complex insurance issues on behalf of our members, working directly with the payer where needed.
• Communicate with our members over video and insurance companies on the phone where necessary.
• Review and process prior authorization and other forms.

You are the ideal candidate if you are:

• Passionate about our mission: You are looking to join a mission-driven team and culture, and are willing to go above and beyond to get the job done
• A great communicator and culture-bearer: You instill Groups’ culture and mission with every patient interaction. You are clear, confident and culturally sensitive in your communication style
• A fast-paced worker: You thrive in a face-paced environment and enjoy meeting patient needs as quickly as possible
• A strong collaborator: You know how to work together with different teams to achieve common goals. You are great at building relationships and are someone whom everyone enjoys working with.
• Data driven: You are a “numbers person” who enjoys looking to the data to evaluate performance.
• Out of the box thinker: You are able to shift the frame from status-quo to innovative solutions. You like to think differently, unconventionally, or from a new perspective
• Exceptionally organized: You know that training involves many moving pieces and know how to keep track of them all without fail
• Flexible: You can juggle multiple priorities, and thrive when faced with ambiguity and rapid change

Qualifications:

• Bachelor’s degree preferred
• At least two years of experience with direct member-facing experience in patient access, financial counseling, and/or utilization management; SUD/Behavioral Health setting strongly preferred.
• Experience speaking with SUD/Behavioral Health patients to interpret their coverage, benefits, patient responsibility, and more.
• Experience working with members via telehealth.
• Experience with state Medicaid portals, (Availity and Zendesk preferred).
• Experience speaking directly with payers and navigating payer organizations to solve problems.
• Experience and working knowledge of commercial, Medicare, and Medicaid plans with behavioral health/SUD coverage and benefits.
• Experience creating and explaining payment plans to SUD/Behavioral Health members.
• Skill in responding quickly to member needs.
• Skill in quickly learning about new insurance plans.
• Skill in operating effectively in a remote environment.Skill in operating electronic medical records (eClinicalWorks experience preferred).
• Skill in operating other needed technology - including video-conferencing, ticketing systems, and more.
• Experience in a high-growth environment strongly preferred.  
• Deeply invested in patient success.