Full-Time

Insurance Eligibility and Financial Counselor

Confirmed live in the last 24 hours

Ophelia

Ophelia

201-500 employees

Provides medication-assisted treatment for opioid dependence

Social Impact
Healthcare

Compensation Overview

$55k - $60kAnnually

Junior, Mid

Remote in USA

Category
Insurance
Finance & Banking
Required Skills
Word/Pages/Docs
Requirements
  • 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 understand.
  • Strong 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.
Responsibilities
  • 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.

Ophelia provides medication-assisted treatment (MAT) for individuals dealing with opioid dependence. Their approach focuses on helping patients manage cravings and withdrawal symptoms through scientifically-backed treatments, which are designed to be more private and convenient than traditional rehab methods. Ophelia differentiates itself from competitors by offering a modern, patient-centric model that emphasizes discretion and empowerment, allowing patients to make informed choices about their treatment. The company's goal is to reduce the stigma surrounding drug rehabilitation and to provide effective alternatives that cater to a diverse clientele, particularly those under 50 who are at higher risk of opioid overdose.

Company Stage

Series B

Total Funding

$65.9M

Headquarters

Philadelphia, Pennsylvania

Founded

2020

Growth & Insights
Headcount

6 month growth

28%

1 year growth

41%

2 year growth

29%
Simplify Jobs

Simplify's Take

What believers are saying

  • Ophelia's recent $50 million Series B funding round, led by Tiger Global, positions the company for national expansion and integration with additional payors and partners.
  • The company's collaboration with Highmark Wholecare and MVP Healthcare expands access to life-saving MAT for over 600,000 people, highlighting its growth potential.
  • Ophelia's leadership team, with new hires from Babylon Health and Omada Health, brings deep experience in value-based care and chronic condition management, enhancing its strategic capabilities.

What critics are saying

  • The competitive landscape for telehealth-based OUD treatment is growing, requiring Ophelia to continuously innovate to maintain its edge.
  • Dependence on temporary DEA telemedicine flexibilities could pose a risk if regulations become more restrictive, impacting Ophelia's service delivery model.

What makes Ophelia unique

  • Ophelia's virtual-first model for opioid use disorder (OUD) treatment sets it apart by removing geographical and logistical barriers, unlike traditional in-person treatment centers.
  • Being designated as Pennsylvania's first virtual-first Center of Excellence (COE) underscores Ophelia's commitment to high standards in evidence-based treatment.
  • Ophelia's partnerships with major health insurers like Highmark Wholecare and MVP Healthcare ensure broader access to medication-assisted treatment (MAT), a critical differentiator in the OUD treatment landscape.

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