Insurance Verification and Benefits Coordinator

Description

Insurance Verification & Benefits Coordinator

Join a Mission-Driven Team Making a Real Impact

ACCESS is seeking an Insurance Verification & Benefits Coordinator who is detail-oriented, proactive, and skilled in navigating payer systems. In this role, you will ensure that all client insurance coverage is verified, accurate, and current—supporting uninterrupted access to services and timely reimbursement.

What You’ll Do

In this role, you will:

• Conduct initial verification of commercial and Medicaid insurance benefits by contacting payer representatives directly.
• Communicate verified benefits and estimated financial responsibility to the Admissions team prior to scheduling initial appointments.
• Document all verification results accurately in the billing system and maintain consistency across records.
• Perform scheduled Medicaid eligibility checks and commercial insurance re-verifications for active clients.
• Identify, track, and communicate payer disruptions to internal teams and clients’ responsible parties.
• Support guardians and families with guidance and follow-up to reinstate or maintain coverage.
• Maintain a payer disruption log and promptly notify the Clinical Billing Manager and Director of Risk, Quality, and Billing Operations of changes impacting reimbursement.
• Enter and maintain verified payer sources to ensure correct routing to primary, secondary, and tertiary payers.
• Coordinate closely with the Billing Department to prevent claim denials caused by payer mismatches.
• Obtain, track, and manage initial and ongoing prior authorizations for commercial insurance plans.
• Monitor authorization expiration dates and initiate renewals proactively to prevent service interruptions.
• Partner with Clinical Services Coordinators, the Waiver Department, and Billing to resolve eligibility and authorization issues.
• Communicate clearly with staff and families regarding insurance requirements, coverage changes, and authorization status.
• Maintain compliance with payer rules and organizational standards related to eligibility and authorization.
• Obtain required referrals (e.g., PCP/PCM referrals) based on payer requirements.
• Complete required in-service and professional development trainings annually.
• Perform other related duties to support ACCESS operations.

Who Thrives in This Role

Professionalism & Accountability

• High ethical standards and respect for confidentiality
• Dependable follow-through and strong ownership of work

Communication & Collaboration

• Clear, professional communication with families, payers, and internal teams
• Ability to navigate sensitive coverage conversations with confidence and empathy
• Collaborative mindset across clinical and billing functions

Organization & Attention to Detail

• Exceptional accuracy in documentation and data management
• Ability to manage multiple payers, deadlines, and priorities simultaneously
• Proactive problem-solving skills with a prevention-focused approach

Requirements

What You’ll Need

• High school diploma or equivalent (required)
• Experience in insurance verification, benefits coordination, healthcare billing, or related healthcare administration (preferred)
• Working knowledge of Medicaid and commercial insurance plans
• Experience communicating directly with insurance payers
• Familiarity with authorization and referral processes
• Proficiency with electronic billing or healthcare systems
• Strong computer skills, including Microsoft Office
• Ability to work independently while supporting a collaborative team
• Successful completion of drug screen and background checks required.

Physical Demands

This position requires frequent sitting and computer work, with occasional standing, bending, or lifting (up to 50 lbs). Vision requirements include close, distance, and peripheral focus.

Travel

This position does not require travel.
ACCESS drivers must maintain a valid driver’s license, insurance, and a clean driving record.

Salary based on experience.