Insurance Eligibility and Financial Counselor
United States
Revenue Cycle Management /
Full Time /
Remote
Are you looking for a role in a company that's solving one of the greatest challenges of our lifetime?
Ophelia helps people end their opioid use and restore their quality of life with respect for their time and dignity. Our Mission is to make evidence-based treatments for opioid use disorder accessible to everyone... and we're looking to bring more people onto our team to help us achieve it.
Opioid overdose is the #1 cause of death for Americans under 50, but 80% of 3 million Americans with opioid use disorder (OUD) are not getting treatment. Most have jobs, families, and privacy concerns, making it easier to get withdrawal medication from a drug dealer than go to rehab. Meanwhile, 2/3rds of rehabs do not offer medication at all, leading 90% of patients to relapse in the first 3 months. As a result of inadequate access to proven treatment, an American dies of an opioid overdose every 11 minutes.
We are a team of world-renowned doctors, scientists, startup veterans, and White House advisors, backed by leading technology and healthcare investors (Y Combinator, General Catalyst) to re-imagine and re-build addiction treatment in America.
Join us, save lives, and help fix healthcare for those who need it most.
The Role:
Our Financial Counselor assists patients with insurance eligibility verification and creates pathways to bill payments. This is a critical role on our team: helping patients understand their insurance coverage, empowering them to make informed decisions, and partnering with them to maintain accounts in good standing with Ophelia. This is a full time, fully-remote role that reports to the Director of Revenue Operations.
The ideal candidate is someone with strong communication and problem-solving skills: you'll need to explain complex insurance topics such as benefit coverages, copays, deductibles, coinsurance and more to people who are brand new to these terms, via phone, email, and chat platforms. You'll provide feedback to management regarding recurring customer issues and suggest improvements in processes to prevent future conflicts. You'll work on a team with other Financial Counselors, Care Coordinators, and Enrollment Coordinators to create a high-quality, compassionate patient experience from the moment a patient considers seeking care with Ophelia to the point where they pay their bills. You'll also need strong attention to detail: you'll address concerns and resolve issues promptly, maintaining accurate and detailed records of patient interactions and issue resolution.
What you'll do:
- Verify Patient health insurance and benefit information and provide timely responses to our patients and care coordination teams.
- Verify insurance through web portals and contacting insurance companies directly.
- Identify any potential non-coverage issues and effectively communicate across all departments and to our patients.
- Communicate with patients as needed to acquire necessary & pertinent information to determine accurate insurance benefits.
- Triage internal group communications regarding patient insurance questions/coverage in real-time with enrollment and care coordination teams
- Perform timely follow-up of new & existing benefits information requests through text messaging and calls.
- Negotiate acceptable payment terms with patients in accordance with Ophelia’s policies and procedures
- Track patients with payment plans or other options to resolve patient account balances
- Other duties as assigned.
What we're looking for:
- 2-4 years of current and relevant experience in insurance verification and financial counseling in a healthcare environment.
- Knowledgeable of all Payer product types including HMO, PPO, Medicare & Medicaid.
- Successfully communicate complex insurance topics such as benefit coverages, copays, deductibles, and coinsurance to patients in a way that they can understandStrong interpersonal skills and ability to communicate across many departments, to insurance companies and patients.
- Ability to de-escalate tense situations, empathize with patients on sensitive topics, and work towards mutually beneficial solutions.
- Excellent computer skills (preferably Google Docs) and experience.
- Utilizing various insurance web portals and computer applications.
- Detail-oriented, a high degree of initiative in tackling work, and eagerness to learn from and collaborate with others on the team
- Be willing and able to work in a fast-paced startup environment and can easily adapt to increased business demands.
Our Benefits Include
- Remote work anywhere in the United States
- Competitive medical, vision, and health insurance (many plans are fully covered for the employee!)
- 20 days of PTO per year
- 10 company holidays
- $1,000 Work From Home Stipend
- 401k Contribution Platform
- Additional benefits offered through our benefits provider such as life insurance, short and long term disability, financial wellness, virtual primary care, among others!
$55,000 - $60,000 a year
Compensation Philosophy: We set compensation based on the level and skills required for the role. We value pay transparency and equity, and are committed to fair pay. In order to prevent pay disparities and reduce time spent in negotiations, we take a “first and best” offer approach: this means we’re not holding any compensation back from our candidates, and you can feel confident that our pay is fair and does not vary based on the strength of someone’s negotiation skills.
Compensation is dynamic at Ophelia: as long as the company performs well and meets our targets, there will be opportunities for increased compensation annually. We’re happy to discuss this approach and our bands if you have questions during the interview process.
#LI-Remote
Interested in learning more about Ophelia and this role? Apply below!
