Behavioral Health Insurance Navigator

Integratedservice; Newark (OH); On-site; USD 44,000 - 53,000; Full time

Benefits offered by this job

Medical

Vision

Short-term Disability

Long-term Disability

401(k) with Employer Match

Employee Assistance Program (EAP)

Job summary

Integrated Services for Behavioral Health (ISBH) seeks a Client Insurance Specialist to verify eligibility, oversee authorizations, and support billing navigation. You will educate staff, streamline workflows, and handle complex payer issues to ensure uninterrupted client care.

The role requires knowledge of Ohio Medicaid, managed care and payer processes, plus 2–3 years in behavioral health insurance support.

Qualifications

• A high school diploma/GED is required.
• An associate or bachelor’s degree in healthcare administration, social work, business, behavioral health, or related fields is preferred.
• 2-3 years of experience in behavioral health insurance verification, authorizations, billing support, utilization review, or healthcare coverage navigation is required.

Responsibilities

• Provide staff education and consultation regarding insurance coverage, payer requirements, eligibility verification, and authorization processes for clients.
• Develop workflows, reference materials, and process improvements to strengthen client insurance communication and navigation across the organization.
• Serve as the escalation point for complex client insurance questions, coverage concerns, and payer‑related barriers affecting client care.
• Monitor and communicate client insurance renewals, dropped coverage, eligibility changes, payer updates, and coverage limitations to staff and departments.
• Extract, track, and organize client insurance renewal and coverage data within the electronic health records systems to support continuity of care and operational workflows.
• Communicate with clients to implement self‑pay agreements, provide good faith estimates, and collect payments when applicable.
• Maintain and distribute internal communication lists and updates related to client insurance changes impacting services or billing.
• Collaborate with patients, direct service providers, intake, billing, scheduling, and clinical teams as needed to ensure accurate and current client insurance information.
• Track Medicaid, managed care, commercial insurance, and OhioRISE or waiver‑related changes that impact authorizations or service access for clients.
• Collaborate with utilization review, prior authorization, and billing staff to resolve client insurance issues and minimize service interruptions.
• Utilize data tracking and analytics to identify trends, coverage gaps, and operational needs related to client insurance management and access to care.
• Maintain compliance with HIPAA, mandated reporting requirements, and professional ethical guidelines.

Skills

Communication skills

Organization

Medicaid knowledge

Data entry

EHR systems

Driver's license

Confidentiality

Team collaboration

Education

High school diploma

Associate or Bachelor's degree preferred

Tools

EHR systems (ECR/HER)

Job description

Integrated Services for Behavioral Health (ISBH) seeks a Client Insurance Specialist to verify eligibility, oversee authorizations, and support billing navigation. You will educate staff, streamline workflows, and handle complex payer issues to ensure uninterrupted client care.

The role requires knowledge of Ohio Medicaid, managed care and payer processes, plus 2–3 years in behavioral health insurance support.