Member Financial Specialist

Job Summary

To support the resolution of Coordination of Benefits (COB) denials, the full-time Member Financial Specialist will manage complex eligibility and coverage issues, educate members about their benefits, and ensure accurate updates to member accounts while working onsite or remotely.

Key responsibilities

• Investigate and resolve COB denials through direct communication with insurance carriers and members
• Update member accounts with verified insurance data and notify members of any changes in benefits or financial responsibilities
• Perform routine and ad-hoc reporting to identify trends in COB denials and coverage discrepancies

Required qualifications

• Bachelor's degree or equivalent combination of education and experience required
• Minimum of 2 years of direct patient-facing experience in patient access, financial counseling, or utilization management; experience in SUD/Behavioral Health strongly preferred
• Strong working knowledge of commercial, Medicare, and Medicaid behavioral health/SUD plans
• Experience communicating directly with payers and navigating insurance organizations
• Access to reliable internet and phone services with specified minimum speeds for remote work