Insurance Specialist - Thrive Program

Description

Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.

This position will serve as a Case Manager for the Transforming Health & Resilience in Veterans (THRIVE) Program and Brain and Body NFLPA Program in Chapel Hill, NC. The THRIVE Program is a community-based clinical outreach program designed to provide care to Veterans and first responders who are experiencing the effects of traumatic brain injuries (TBI) or post-traumatic stress (PTS) resulting from a career serving our nation. The program provides a 3-day diagnostic evaluation, 3-week intensive outpatient program, and continued follow up for up to 12 months after evaluation. The Brain and Body Program is a wellness benefit for former NFL Players from the NFLPA Trust. The program provides a 3-day medical evaluation and follow up to assist players with their recommendations. This position will be responsible for providing structured follow up and community support to participants in both programs.

Summary:

Reporting to the Practice Manager, the
Insurance Specialist is responsible for the timely verification of medical
insurance benefits through telephonic and electronic communication with private
insurance companies, Medicare, and Medicaid, TriCare, and VA to obtain benefit
information and determine insurance compatibility with health-care provider
programming. This position supports
program sustainability by ensuring all prior authorization work is completed
prior to patient arrival.

Responsibilities:
Coordinates and communicates with patient regarding their insurance benefits and medical providers programs, re-verifying existing patient insurance coverage, and determining if an insurance benefit plan considers selected products appropriate based on patient need.
Obtains pre-certification or authorization, verify insurance for all patients, including support for those who may be underinsured or uninsured.
Schedules all new and follow-up patient appointments as required. Attempt to reschedule cancellations whenever possible. Communicates cancellations to provider as necessary.
Manages incoming and outgoing referrals. Follows referral management policies and procedures.
Answers telephones, directs calls, takes and delivers messages in Epic.
Ensures excellent customer service by consistently demonstrating a caring, positive, professional, and helpful disposition with all customer relations.
Performs miscellaneous duties as needed to support administrative operations of the practice.

Other Information

Job Details

Legal Employer: NCHEALTH

Entity: UNC Physicians Network

Organization Unit: Thrive Program

Work Type: Full Time

Standard Hours Per Week: 40.00

Salary Range: $16.81 - $24.16 per hour (Hiring Range)

Pay offers are determined by experience and internal equity

Work Assignment Type: Onsite

Work Schedule: Day Job

Location of Job: US:NC:Chapel Hill

Exempt From Overtime: Exempt: No

This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Heath Care System. This is not a State employed position.

Qualified applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email applicant.accommodations@unchealth.unc.edu if you need a reasonable accommodation to search and/or to apply for a career opportunity.