Behavioral Health Insurance Navigator & Authorizations

Integratedservice; New Lexington (OH); On-site; USD 27,552 - 33,062; 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 in Ohio is seeking a Client Insurance Specialist for the southeastern region to support insurance eligibility, authorizations, and billing processes.

The role emphasizes workflow development, data tracking in EHR systems, and collaboration with clinical teams to ensure continuous coverage and timely payment.

A high school diploma is required; 2–3 years in behavioral health insurance navigation preferred; travel within designated areas.

Qualifications

• High school diploma or GED is required.
• Associate or Bachelor’s in healthcare administration, social work, business, behavioral health, or related field preferred.
• 2–3 years of experience in behavioral health insurance verification, authorizations, billing support, utilization review, or healthcare coverage navigation is required.
• Experience working within a community mental health or healthcare environment is preferred.
• Advanced communication and organizational skills are required.
• Knowledge of Ohio Medicaid, managed care organizations, behavioral health benefits, and payer authorization processes is required.
• Ability to maintain confidential information is required.
• Proficient in Microsoft Excel, Word and Outlook 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 (ECR/HER) 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.
• Travel with designated service areas.
• All other duties as assigned.

Skills

Advanced communication

Advanced organizational skills

Driver's license

Data entry / reporting

Education

High school diploma/GED

Associate or Bachelor’s degree in healthcare administration, social work, business, behavioral health, or related fields

Tools

Microsoft Excel

Microsoft Word

Microsoft Outlook

Job description

Integrated Services for Behavioral Health in Ohio is seeking a Client Insurance Specialist for the southeastern region to support insurance eligibility, authorizations, and billing processes.

The role emphasizes workflow development, data tracking in EHR systems, and collaboration with clinical teams to ensure continuous coverage and timely payment.

A high school diploma is required; 2–3 years in behavioral health insurance navigation preferred; travel within designated areas.