Insurance Verification & Authorization Specialist

Role overview

Help children and families move through the insurance steps needed to access behavioral health services. You’ll check coverage, coordinate authorizations and referrals, and work with patients, insurers, and internal teams to resolve barriers and keep requests moving accurately through a high-volume workflow.

Responsibilities - Verify eligibility, coverage, and behavioral health benefits for new and existing patients. - Review incoming requests for age, location, participating coverage, and service eligibility. - Identify plan-specific requirements, including those handled by third-party behavioral health administrators. - Submit and track prior authorizations and referrals to support timely access to care. - Contact insurers to resolve discrepancies and explain copays, coinsurance, deductibles, and other patient costs. - Document work in ticketing and electronic health record systems, coordinating with colleagues to address coverage issues.

Requirements - Experience with insurance verification, benefits review, eligibility checks, prior authorizations, or referrals in a healthcare setting. - Understanding of insurance costs and terminology, including copays, coinsurance, deductibles, and out-of-pocket expenses. - Strong attention to detail and ability to investigate discrepancies while managing a substantial workload. - Clear communication, organization, and problem-solving skills when working with patients, insurers, and colleagues. - Ability to protect patient confidentiality and follow applicable privacy requirements.

Nice to have - Background in behavioral health benefits, authorizations, or specialty care. - Familiarity with electronic health record systems and insurer portals.

Benefits and work setup - Full-time, hourly position with benefits; fully remote, with preference for candidates in the Eastern Time Zone. - Monday through Friday during Eastern business hours. - Listed pay is $23–$25 per hour.