Insurance Specialist

Community-Council-Health-Systems; Philadelphia (Philadelphia County); On-site; USD 45,000 - 60,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Retirement plan

Paid time off

Professional development

Job summary

Community Council Health Systems in Philadelphia seeks an Insurance Specialist to ensure that all consumers have active insurance coverage, collect co-pays, and maintain accurate documentation in Credible to support billing and service delivery.

Responsibilities include verifying Medicaid, Medicare, and commercial eligibility through portals such as 270/271, Novitasphere, Availity, and NaviNet, updating records, and collaborating with internal programs while protecting confidentiality.

Qualifications

• High School Diploma/GED required; college degree preferred.
• Minimum two years of experience in insurance or billing.
• Strong accuracy and attention to detail to ensure proper billing.

Responsibilities

• Insurance Verification & Documentation
• Verify Medicaid/Medicare eligibility and coverage using the Promise, Novitasphere portals.
• Perform commercial insurance verification via payer portals (Availity, NaviNet, etc.).
• Ensure current insurance cards and supporting documentation are uploaded to Credible.
• Maintain confidentiality and handle participant insurance information per policies.

Job description

About the Organization Our services are designed to be holistic, geographically accessible, culturally sensitive, and coordinated with other related service systems, both formal and informal. Community Council has a long history of providing mental health services to Philadelphia residents and is one of the City of Philadelphia's original 12 Base Service Units. We provide a range of mental health and substance abuse direct services and case management. The organization has a diverse staff of 200 that deliver evidenced based services in a culturally competent manner.

EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.

Benefits of Working With Us

Working at Community Council Health Systems (CCHS) means being part of a compassionate and mission-driven organization dedicated to empowering individuals and families through mental wellness and community support. We foster an inclusive and collaborative work environment where every team member’s contributions are valued and encouraged. At CCHS, employees have opportunities for professional growth, ongoing learning, and career development. We prioritize work-life balance and offer a comprehensive benefits package, including competitive salaries, health, dental, and vision insurance, retirement plan options, paid time off, and professional development opportunities. By joining our team, you become part of a dynamic organization committed to innovation, integrity, and making a meaningful impact in the communities we serve.

General Overview

The Insurance Specialist ensures that all consumers have active insurance coverage, required co-payments are collected, and accurate documentation is maintained in Credible to support billing and service delivery.

Key Responsibilities

Insurance Verification & Documentation

• Perform insurance eligibility and coverage verification for individuals with Medicaid coverage using the Promise portal.
• Process bulk insurance eligibility verification and documentation through 270/271 transactions within the EHR system.
• Verify Medicare eligibility and coverage using the Novitasphere portal.
• Conduct commercial insurance verification through various payer portals, including Availity, NaviNet, and other applicable systems.
• Review insurance verification results and update insurance information within the EHR system accurately and timely.
• Communicate and collaborate with internal programs regarding insurance changes, eligibility updates, and coverage-related issues.
• Follow up with participants and/or internal programs to obtain current physical copies of insurance cards and other required insurance documentation.
• Ensure current insurance cards and supporting documentation are uploaded to and maintained accurately within Credible when insurance information changes.
• Identify individuals who no longer meet insurance eligibility requirements for their respective program and issue appropriate correspondence regarding changes in eligibility or coverage.
• Maintain working knowledge of insurance eligibility requirements and program-specific coverage criteria for CCHS services, including Outpatient, IBHS, Resiliency Center, NFA, CBCM, and MSS.
• Monitor insurance information for accuracy and completeness and identify discrepancies requiring follow-up or resolution.
• Maintain confidentiality and handle participant insurance information in accordance with organizational policies, applicable regulations, and privacy requirements.
• Monitor self-pay accounts and coordinate the collection and resolution of outstanding statement balances in accordance with organizational policies and established procedures.
• Generate, review, and analyze reports to ensure required data is complete, accurate, and available for enrollment processes and MHX reporting requirements.

Position Requirements

Minimum Qualifications

• High School Diploma/GED required, college degree preferred.
• Minimum two (2) years of experience in insurance or billing.
• Strong accuracy and attention to detail to ensure proper billing and insurance processing.

Location Community Council

Number of Openings 1

Full-Time/Part-Time Full-Time

Category Administration

Salary/Sign-on bonus

Close Date

Created By Donna Mims

Number Filled 0

Exempt/Non-Exempt Exempt

Hiring Manager(s) Sharon Johnson

Open Date 10/9/2026

This position is currently accepting applications.