Addiction Recovery Program Insurance Coordinator/Resource Specialist

Principal Duties and Responsibilities

• Manage the ATS phone line by answering patient calls during work hours and returning voicemails about direct admission.
• Coordinate with the emergency department for patients interested in ATS admission.
• Verify ATS insurance coverage and submit authorization after clinical acceptance.
• Complete a standardized substance use intake and present the patient to the attending physician for an admission decision.
• Coordinate with the patient, admitting staff, and nursing staff to schedule direct admission.
• Complete prior authorizations for medically necessary stay extensions.
• Attend the interdisciplinary team meeting Monday–Friday at 1 p.m. to review care and disposition plans.
• Partner with ATS and addiction consult clinicians to transition patients to further treatment, following clinical leadership and coordinating care and resource use.
• Refer patients to appropriate levels of care by providing required clinical documentation, coordinating facility transfers and intake appointments, arranging outpatient follow-up, and helping patients obtain a PCP when needed.
• Build effective relationships with internal programs, outside agencies, facilities, payors, and community resources to support patient and family disposition plans.
• Educate patients about available resources and SUD services, clarify care goals, and help reduce barriers to achieving them.
• Provide flexible support as patient goals or plans change.
• Collaborate with ATS clinicians to identify needed supports and connect patients with services.
• Explain financial services and self-pay resources as needed.
• Follow federal and state requirements and obtain appropriate releases before sharing patient information.
• Provide practice staff coverage as needed.
• Perform related tasks that improve patient flow or quality of care.
• Document all in-person and phone care-coordination communications in the MGB electronic medical record.

Qualifications

• Associate degree required; bachelor’s degree preferred.
• Two to three years of mental health care experience preferred, especially in substance use disorders.
• Strong communication, collaboration, customer service, advocacy, organization, and time-management skills.
• Sound judgment and the ability to work independently, multitask, solve problems, and adapt in a fast-paced environment.
• Strong computer skills and familiarity with addiction treatment, systems of care, and community resources.