Position Overview: The Mental Health Referral Coordinator & Insurance Verification Specialist is responsible for coordinating mental health referrals, verifying insurance coverage, managing IOP (Intensive Outpatient Program) authorization requests, and ensuring the smooth processing of insurance claims for clients seeking mental health services. This role acts as a liaison between clients, insurance companies, and mental health providers to ensure that services are covered and that patients are referred to the appropriate mental health professionals.

Key Responsibilities:

Referral Coordination:

Manage and track referrals for mental health services.

Collaborate with healthcare providers to ensure timely scheduling of appointments for referred clients.

Ensure all necessary documentation is gathered and processed for client referrals.

Insurance Verification:

Verify client insurance coverage for mental health services, ensuring eligibility and benefits are accurate.

Work closely with insurance companies to obtain pre-authorizations, verify coverage limits, and secure approval for services.

Provide clients with information about their insurance benefits and out-of-pocket expenses.

IOP Authorization:

Manage and submit authorization requests for Intensive Outpatient Programs (IOP).

Work directly with insurance providers to obtain approval for IOP services.

Follow up on pending authorizations and resolve any issues related to IOP approval to ensure clients receive timely services.

Maintain thorough documentation of all IOP authorization requests and approvals.

Documentation & Records Management:

Maintain accurate records of all referral and insurance verification activities.

Ensure all client information is confidential and handled in accordance with HIPAA regulations.

Document and update client insurance information regularly.

Client Interaction:

Serve as the point of contact for clients regarding insurance and referral inquiries.

Provide clear, timely communication to clients regarding their insurance verification status, referral updates, and next steps.

Assist clients in resolving any insurance-related issues or concerns.

Collaboration with Providers:

Collaborate with mental health professionals to ensure timely access to services for clients.

Ensure providers have the necessary insurance information to proceed with services.

Follow-up & Support:

Follow up with insurance companies and clients to ensure services are approved and appointments are kept.

Provide ongoing support to clients in understanding their insurance options and mental health benefits.

Qualifications:

Education:

High school diploma or equivalent required. Associate’s degree or higher in healthcare administration or a related field preferred.

Experience:

Previous experience in insurance verification, mental health coordination, or a healthcare administrative role preferred.

Knowledge of mental health services, insurance plans, and healthcare regulations is a plus.

Familiarity with IOP authorization processes and insurance company protocols is strongly preferred.

Skills:

Strong communication and customer service skills.

Attention to detail and ability to manage multiple tasks simultaneously.

Ability to work independently and as part of a team.

Familiarity with insurance systems, mental health service documentation, and HIPAA compliance.

Physical Requirements:

Ability to sit at a desk for extended periods of time.

Must be able to communicate effectively both in person and over the phone.