About this role
Role Description
Athena Care is looking for a VIE Specialist to support our insurance verification efforts for our patients.
Collect, review, and validate all patient insurance information necessary to complete accurate eligibility and benefits verification. Identify behavioral health carve-outs and determine the appropriate payer responsible for mental health benefits. Review and interpret Coordination of Benefits (COB) information to determine primary and secondary payer responsibility. Document eligibility and benefit information accurately within the electronic health record and other designated systems. Utilize payer websites, provider portals, Availity, and telephone verification to obtain accurate benefit information. Communicate eligibility findings, authorization requirements, and financial responsibility to appropriate internal departments. Identify discrepancies in insurance information and work proactively to resolve issues. Maintain productivity and quality standards while managing a high-volume workload. Stay current on payer policy updates, insurance regulations, and behavioral health reimbursement requirements. Maintain patient confidentiality and comply with HIPAA regulations and organizational policies.
Qualifications
Minimum of 4 years of insurance eligibility and benefits verification experience. Minimum of 2 years of behavioral health insurance verification experience. Extensive experience navigating payer portals and Availity. Strong understanding of insurance terminology, benefit structures, and behavioral health coverage. High level of accuracy and attention to detail. Experience using eClinicalWorks (eCW) not required but a bonus.
Requirements
Excellent verbal and written communication skills. Strong organizational and time management abilities. Exceptional attention to detail and accuracy. Ability to navigate multiple software applications simultaneously. Strong analytical and problem-solving skills. Adaptability and flexibility in a changing work environment. Strong customer service and patient-centered mindset. Collaborative, professional, and team-oriented approach. Ability to work independently in a remote environment while maintaining productivity and accountability. Ability to maintain confidentiality and exercise sound judgment.
Benefits
Health, dental, vision, and life insurance. 401(k) with employer match. And more!