Patient Financial & Eligibility Specialist

Job Title: Patient Financial and Eligibility Specialist

Reports To: Vice President of Revenue Cycle Management

Location: Corporate Office in Meridian, ID

Schedule: 8-5pm MST; Hybrid with alternating 1 week in office and 1 week remote

Compensation: $20-22/hour

Northpoint Recovery Holdings, LLC began 2009 as Ashwood Outpatient and officially launched the Northpoint platform in 2015. Now celebrating 10 years of growth in 2025, Northpoint is a leading behavioral healthcare provider offering evidence-based treatment for adults with substance use and co-occurring disorders through the Northpoint Recovery brand, and mental health treatment for adolescents through Imagine by Northpoint. Operating under an in-network, commercial insurance model, Northpoint has grown exclusively through de novo expansion—from two facilities to seventeen across the Western U.S.—with more planned in both existing and new markets. We’re guided by core values of humility, heart, inspiration, and conviction. Our mission is simple: saving lives and restoring relationships by helping people get their lives back, and treating every individual with empathy and respect.

POSITION SUMMARY: As a key member of the Revenue Cycle Management upstream team, the Patient Financial & Eligibility Specialist is a critical role with primary responsibility for verifying eligibility and benefits for all incoming patient per insurance plan, audit and review patient demographic and insurance information for accuracy. The position will work with the admission department and the patients to create financial agreement based on stated plan benefits and patient responsibility. The Patient Financial & Eligibility Specialist will work closely with the Billing & Collections Manager as well as the Dir of Admission to ensure cohesion with the admission process regarding payer source and information gathered.

ESSENTIAL RESPONSIBILITIES AND DUTIES INCLUDE:

• Call insurance companies to obtain eligibility & benefits for substance abuse/behavioral health services for all incoming clients.
• Obtain & gather benefit details such as coverage level, exclusions, patient responsibility such as co-pays, deductibles, co-insurance and/or out of pocket maximums.
• Provide expertise in verifying insurance policies, eligibility criteria, and plan benefit details.
• Develop and maintain relationships with payors, facility providers, UR staff, and other stakeholders of the RCM process.
• Accurately fill out VOB forms with all necessary information for a proper admission process
• Complete and return benefits request in a concise and clear manner with detailed information on patient benefits & responsibility.
• Works directly with the clients and/or payers to determine client responsibilities prior to admission.
• Complete client financial responsibility agreements which specify client’s and/or other responsible parties’ responsibility for point of service cash collection.
• Counsel clients and/or responsible parties throughout the treatment continuum.
• Provide patient financial counsel around patient payment plans, track and monitor timely point of service cash collections on all payment plan & agreement.
• As needed assist with downstream patient account receivables post discharge collection.
• Effectively monitor the verification process during the upstream process of the patient claim life cycle.
• Support and promote Northpoint’s core values, mission and treatment philosophy.
• Maintain confidentiality in accordance with established policies and procedures and standards of care.
• Adhere to all Company policies and procedures.
• Perform other job-related duties as assigned.

QUALIFICATIONS/REQUIREMENTS FOR POSITION:

• 3 years of experience in medical and/or behavioral health setting required
• 1 year of experience working with Medicaid and commercial medical insurance billing required
• Demonstrated knowledge of the technical aspects of revenue cycle management
• Strong understanding of CPT and ICD-10/DSM5 and payer plan benefits
• Strong knowledge of insurance and managed care plans to include benefits structures
• Must be self-starter, self-motivated, organized and detail oriented
• Demonstrated ability to develop both internal and external working relationships
• Proven skills in working independently on several projects concurrently

PREFERRED KNOWLEDGE AND SKILLS:

• Excellent critical thinking skills and organizational abilities
• Excellent communication skills: ability to communicate clearly and concisely, verbally and in writing
• Quickly and effectively identify and resolve problematic situations
• Comfortable analyzing information and dealing with complexity
• Attention to detail and accuracy
• Able to handle confidential material in a reliable manner
• Ability to interact and communicate with individuals at all levels of organization
• Ability to perform several tasks concurrently with ease and professionalism
• Ability to effectively prioritize workload in a fast-paced environment
• Proficiency with Microsoft Office Suite

This job description is not intended, and should not be construed, to be exhaustive lists of all responsibilities, skills, efforts or working conditions associated with this job. It is meant to be an accurate reflection of the principal job elements essential for making fair pay decisions about jobs.

Employees with potential access to protected health information must comply with all procedures and guidelines governed by HIPAA.

Northpoint is an Equal Opportunity Employer. Northpoint is an at-will employer. Employment may be terminated at any time by employee, or employer with or without notice.