Insurance Eligibility Verification Specialist

🕒 June 9

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Pinnacle Treatment Centers, Inc.

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2006

🧘 Wellness

👥 B2C

🌍 Social Impact

Wellness • B2C • Social Impact

<Pinnacle Treatment Centers, Inc. > Pinnacle Treatment Centers, Inc. operates a nationwide network of addiction treatment facilities offering inpatient, outpatient, detox, medication-assisted treatment (MAT), and behavioral therapies. The organization provides evidence-based programs for substance use disorders (including opioids, alcohol, meth, fentanyl, stimulants, prescription drugs) and co-occurring mental health conditions, with services such as individual, group, and family therapy, trauma support, mindfulness, and complementary therapies. Pinnacle emphasizes accessibility (135+ locations), accreditation from CARF, AATOD, NABH, and RCPA, insurance acceptance including Medicaid and Medicare OTPs, and 24/7 admissions support to help patients start recovery quickly.

📋 Description

• Responsible for verifying patients’ insurances, as well as their covered benefits and for confirming pre-authorizations for services. • Works well as part of a team and effectively communicates. • Assists practice staff with eligibility, as necessary. • Serves as a liaison between the RCM department and the various PTC facilities. • Handle high volume of inbound/outbound calls for patients that need to be screened financially and medically for financial assistance. • Complete verification of benefits for multiple clients within the appropriate timelines. • Maintains high quality customer service standards in compliance with federal and state regulations and guidelines. • Provide periodic processing status updates. • Assist in researching reimbursement issues relevant to benefits/eligibility issues. • Assist in training of new team members. • Enter and update patient demographics into the billing system as needed. • Complete KPI reports as requested by management and the clients. • Update and manage the VOB tracker for multiple clients. • Understand federal and state requirements regarding client confidentiality and the principles of maintaining protected health information (PHI). • Work effectively and maintain expected productivity. • Other tasks or duties as assigned.

🎯 Requirements

• Associate’s degree preferred or experience in lieu of degree. • 1-2 years'+ experience in front-end medical office operations. • Prior experience working in a role with a high volume of either inbound or outbound calls. • Experience and knowledge of federal or state government agencies including Social Security, Medicaid and/or Commercial coverages, familiar with the healthcare revenue cycle touching patient accounts. • Experience working in a role that requires prioritization of multiple critical priorities while ensuring quality and achievements of performance metrics. • Experience with customer interactions which requires live, accurate documentation of the encounter. • Previous experience collecting patient payments or copays.

🏖️ Benefits

• 18 days PTO (Paid Time Off) + 8 paid holidays • 401k with company match • Company sponsored ongoing training and certification opportunities. • Full comprehensive benefits package including medical, dental, vision, short term disability, long term disability and accident insurance. • Substance Use Disorder Treatment and Recovery Loan Repayment Program (STAR LRP) • Discounted tuition and scholarships through Capella University