Description: Company Overview
Tree of Life Counseling Center, LLC is a family owned, for-profit, growing mental health private practice headquartered in Freehold, NJ with another location in Princeton, NJ. We have been operating since 2016 and currently have a growing team of over 50 clinicians and 8 administrative staff supporting our mission. We accept almost every major insurance and have a growing waiting list of clients needing care. Our offices provide a warm and relaxing environment for both staff and clients and both of our locations provide group rooms, craft rooms (for children), sand-tray therapy, music therapy, art therapy and more. We have over 50 therapy rooms across our two locations with clinicians specializing in talk therapy and EMDR for anxiety, trauma, family issues, LGTBQ and more. In addition, we have practitioners offering reiki, group classes for meditation, breathing, and yoga. More information is available at www.treeoflifecc.org.As a key contributor to clinical and revenue cycle operations, a Patient Eligibility Specialist plays a pivotal role in managing patient information, verifying patient treatment eligibility through meticulous insurance processes, and supporting patient care through the accurate preparation of medical charts. This role demands a dynamic individual capable of navigating complex insurance systems and contributing positively to team dynamics.
Position Overview

• Insurance Verification : Confirm patient insurance details, including detailed benefits and referrals, to ensure eligibility and secure financial reimbursement ahead of appointment dates. Responsible for verifying health insurance benefits for all new patients or existing patients. Consistently review eligibility responses in insurance verification system.
• Chart Management: Review electronic medical charts, ensuring that all pertinent information is listed in the medical chart. Responsible for entering data in an accurate manner in order to update patient benefit information correctly in EMR and verify that existing information is accurate
• Financial Clearance: Accurately gather and verify all patient demographic, financial, and insurance information, ensuring comprehensive financial clearance. This includes obtaining necessary referrals, authorizations, and pre-certifications to mitigate denials and secure reimbursement
• Patient Communication: Inform patients/guarantors about their benefits, authorization needs, and out-of-pocket responsibilities, including co-pays, deductibles, and co- insurance. Notify patient and help arrange alternative payment methods when insurance coverage does not cover services.
• Prior Authorization : Efficiently manage prior authorization demands, including reviewing patient diagnoses, communicating with insurance carriers, and utilizing insurance portals for submission
• Compliance and Communication : Maintain patient confidentiality, contribute positively to team dynamics, and engage in continuous professional development through meetings. Maintain service standards in accordance with the departmental/organizational policies.

Requirements:

• Insurance Knowledge: Familiarity with insurance referral and reimbursement criteria
• Experience in healthcare administration a plus
• Communication: Exceptional verbal and written communication skills
• Analytical Proficiency: Strong critical thinking, analytical, and problem-solving abilities, coupled with excellent patient care orientation
• Excellent interpersonal skills and ability to work effectively with physicians, co-workers, other departments and patients of all ages, and from across a broad range of cultural and social economic backgrounds
• Ability to show tolerance and sensitivity in stressful situations and safeguard confidential information in accordance with established policies and HIPAA regulations
• Demeanor: Personable, outgoing, and friendly, fostering positive interactions and relationships
• Work Ethic: Demonstrates flexibility and adaptability, capable of thriving independently and as an integral part of a team in dynamic environments
• Self-Management: Ability to work independently in a fast-paced environment, maintaining professionalism and confidentiality in line with HIPAA regulations
• Technical Skills: High proficiency in Google Apps, especially Sheets, and the ability to navigate and master various electronic systems. Knowledge of Monday.com helpful.
• Ability to Make an Impact: Inspired to perform well by the ability to contribute to the success of a project or the organization
• Growth Opportunities: Inspired to perform well by the chance to take on more responsibility.
• Education: High School Diploma or GED required