Administration-Insurance Coordinator - Grants Pass - Kairos

    Kairos
    Kairos Grants Pass

    1 day ago

    Description
    Primary Purpose
    The insurance Coordinator is responsible for managing all insurance-related processes for behavioral health services, including eligibility verification, prior authorizations, benefits coordination, claims support, and payer communications. This role ensures accurate insurance processing, compliance with payer requirements, and a smooth financial experience for clients receiving in-office and telehealth behavioral health services.
    The ideal candidate has strong behavioral health insurance experience, understands mental health CPT/diagnosis codes, and is highly detail-oriented, organized, and client-centered.
    Education and Experience
    Minimum 3-4 years of insurance coordination experience, preferably in behavioral or mental health. Strong knowledge of behavioral health insurance benefits, authorizations, and payer rules. Familiarity with CPT, ICD-10, and behavioral health billing workflows. Experience working with Medicaid, Medicare, and commercial payers. Proficiency with EHR and billing systems. Excellent organizational, communication, and problem-solving skills. High attention to detail and ability to manage multiple cases simultaneously. Preferred Experience with telehealth behavioral health billing and authorizations. Knowledge of state-specific behavioral health payer requirements. Experience in a nonprofit or community mental health setting. Bilingual (preferred but not required)
    Minimum Qualifications
    • Provide proof of current, valid Oregon Driver's License (or if out-of-state will obtain Oregon license within 30 days), comprehensive automobile insurance (if applicable) and a safe driving record (minimum of 3 yrs.) to use company or personal vehicle for required duties.
    • Successfully pass a Criminal Background Check and Medicaid Fraud Check.
    Essential Duties, Responsibilities and Core Competencies
    Insurance Verification & Benefits
    • Verify insurance eligibility and behavioral health benefits prior to services
    • Confirm coverage for in-office and telehealth behavioral health services
    • Review co-pays, deductibles, coinsurance, visit limits, and authorization requirements
    • Accurately document benefits and financial responsibility in the EHR/billing system
    Authorization & Utilization Management
    • Obtain and manage prior authorizations for behavioral health services
    • Track authorization start/end dates, approved units, and reauthorization timelines
    • Coordinate with clinicians to obtain required clinical documentation
    • Communicate authorization status to internal teams and clients as appropriate
    Claims & Payer Communication
    • Serve as a liaison between the organization and insurance companies
    • Resolve insurance issues related to coverage, denials, or payment discrepancies
    • Follow up with payers regarding claims status and required documentation
    • Assist billing team with insurance-related claim correction and appeals
    Client & Team Support
    • Provide clear, compassionate explanation of insurance benefits to clients
    • Support clinicians and scheduling staff with insurance-related questions
    • Maintain confidentiality and compliance with HIPAA and behavioral health regulations
    • Collaborate closely with billing, finance, and clinical teams
    Compliance & Documentation
    • Ensure insurance processes comply with payer contracts and state/federal regulations
    • Maintain accurate, timely documentation of insurance activity
    • Assist with audits, reporting, and quality assurance related to insurance processes
    Safety and Work Environment
    • Abide by ethical codes, mission, values, and professional standards, including confidentiality.
    • Actively utilize, reference, and follow agency policies, procedures, and guidelines.
    • Present a positive attitude, professional demeanor and demonstrated respect with youth and young adults, families, staff, visitors, and community partners.
    • Perform all work tasks in a proper and safe manner per established policies, procedures, and guidelines to prevent unnecessary injury, time loss and agency expense.
    • Comply with all federal, state and agency health and safety reporting requirements.
    Requirements
    In order to be considered for a position with Kairos, applicants must meet and agree to the following requirements:
    • Meet all Education and/or Experience Requirements listed for the specific position.
    • Provide references upon request.
    • Request official transcripts upon offer of employment.
    • Provide proof of current, valid Oregon Driver's License (or if out-of-state will obtain Oregon license within 30 days), comprehensive automobile insurance (if applicable) and a safe driving record (minimum of 3 yrs.) to use company or personal vehicle for required duties.
    • Successfully pass a Criminal Background Check and Medicaid Fraud Check.

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