Verification of Benefits and Authorization Specialist (Remote)Verification of Benefits and Authorization Specialist (Remote)
Happy HealthStraight from Happy Health’s careers page. Apply on the company site — no recruiter, no middleman.
Verification of Benefits & Authorization Specialist
Team: Revenue Cycle
Location: Remote
Commitment: Full-Time
Workplace Type: remote
Salary:
Work Environment:
The team is remote, with a physical office in Austin, TX. Direct peers are distributed throughout the continental US. This role is expected to operate with a high degree of autonomy and leadership in a distributed environment.
Benefits:
- 100% premium coverage for employees Health, Dental, and Vision Insurance. 50% premium coverage for dependents.
- 401k platform
- WFH Stipend
About Us
Happy Health is revolutionizing sleep medicine delivery through our comprehensive telehealth platform. Weve eliminated the traditional barriers to sleep care – no more waiting months for appointments or spending uncomfortable nights in sleep labs. Our patients receive FDA-cleared home sleep testing via Happy Ring, connect with board-certified sleep specialists, and when required, begin evidence-based treatment within just 5 days. Ongoing physiological data monitoring with the Happy Ring enables real-time condition management, combination therapies, and drives measurable outcomes.
Happy Ring represents the future of sleep diagnostics: an FDA-cleared medical device integrating advanced biometric sensors with AI-powered analysis to deliver highly accurate diagnostics and longitudinal management at home. For sleep medicine physicians, this means youll have access to high-quality diagnostic data that empowers you to make confident clinical decisions for your patients, and integrate multimodal treatments that focus on root-cause solutions.
The ideal candidate thrives on accuracy, knows their way around payer portals, and can juggle multiple authorization requests while keeping providers and patients informed every step of the way.
Key Responsibilities:
- Verify patient insurance eligibility and benefits (in-network and out-of-network) prior to scheduled appointments, procedures, and services via payer portals, clearinghouses, and phone
- Obtain, track, and follow up on prior authorizations and retrospective authorizations for office visits, diagnostic testing, and procedures
- Accurately document benefit details, authorization numbers, effective dates, and payer requirements in the practice management system / EHR
- Calculate patient financial responsibility (copays, coinsurance, deductibles) to front-office staff and patients
- Identify authorization requirements by payer and CPT code, and flag services at risk of denial before they are rendered
- Monitor pending authorizations and proactively escalate delays that could impact patient care or scheduling
- Collaborate with providers, clinical staff, schedulers, and billing to resolve coverage issues and reduce claim denials
- Respond to authorization-related denials by gathering documentation and initiating appeals or retro-authorizations when appropriate
- Stay current on payer policy changes, medical necessity criteria, and authorization workflows
- Maintain compliance with HIPAA and all applicable privacy and security standards
Required Qualifications
- High school diploma or equivalent
- Minimum of four (4) years of experience in insurance verification, prior authorization, retrospective authorizations or medical billing in a physician practice or outpatient setting
- Working knowledge of commercial insurance, Medicare, and Medicaid plans, including HMO/PPO structures and authorization processes
- Familiarity with CPT, ICD-10, and HCPCS coding as it relates to eligibility and authorization
- Experience using payer portals (e.g., Availity) and practice management / EHR systems
- Strong attention to detail, organization, and follow-through
- Excellent written and verbal communication skills
- Ability to work independently in a remote environment with reliable high-speed internet and a private, HIPAA-compliant workspace
Preferred Qualifications
- Bilingual (English/Spanish)
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