Insurance Verification and Authorization Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Verify insurance eligibility, coverage, and behavioral health benefits for both new and existing patients.

• Review incoming inquiries from patients to confirm their age, location, insurance participation, and eligibility for services.

• Identify complexities within insurance plans, which may include third-party behavioral health administrators and specific payer coverage requirements.

• Obtain, submit, and track prior authorizations and referrals.

• Communicate with insurance carriers to address coverage discrepancies and clarify patient financial responsibilities, including copays, coinsurance, and deductibles.

• Manage a high volume of requests through internal ticketing systems and electronic health record (EHR) platforms.

• Maintain precise documentation and collaborate with internal teams to eliminate barriers to care.

• Assist children and families in accessing pediatric mental health services.

⛳️ Requirements

• Experience in healthcare insurance verification, benefits determination, eligibility, prior authorizations, or referrals.

• Strong understanding of insurance terminology, including copays, coinsurance, deductibles, and out-of-pocket expenses.

• Exceptional attention to detail with the capability to manage high-volume workflows, investigate coverage discrepancies, and ensure accuracy.

• Strong communication, organizational, and problem-solving abilities.

• Experience with behavioral health insurance benefits, prior authorizations, or specialty healthcare is a significant advantage.

• Familiarity with EHR systems such as Athenahealth and insurance portals is a valuable asset.

• Ability to maintain patient confidentiality and adhere to HIPAA regulations.

• Availability to work Monday through Friday during Eastern Time business hours.

• Preference for candidates located in the Eastern Time Zone.

🏝️ Benefits

• Eligible for benefits.

• Full-time employment opportunity.

• Hourly (non-exempt) compensation structure.

• Fully remote work arrangement.