Insurance Verificiation and Authorization Specialist

Job Summary

We are seeking a detail-oriented Insurance Benefits Verification and Authorization Specialist to join our Behavioral Health team. This role is responsible for verifying patient insurance benefits, obtaining prior authorizations for services, and ensuring accurate documentation to support timely billing and reimbursement. The ideal candidate has experience working with behavioral health insurance policies and strong communication skills when interacting with insurance companies, providers, and administrative staff.

Key Responsibilities

• Verify patient insurance eligibility and behavioral health benefits prior to scheduled appointments.
• Contact insurance companies to confirm coverage details, copays, deductibles, coinsurance, and authorization requirements.
• Obtain prior authorizations for behavioral health services including therapy, psychological testing, and other clinical services.
• Accurately document insurance verification details in the Electronic Health Record (EHR) or billing system.
• Communicate authorization status and benefit information with providers and administrative staff.
• Track authorization approvals, expirations, and follow up on pending requests.
• Assist with resolving insurance verification issues that may impact billing or patient scheduling.
• Maintain compliance with HIPAA and confidentiality standards.
• Support the billing department with claim-related insurance inquiries when needed.

Qualifications

• 1–2 years of experience in insurance verification or medical authorization (Behavioral Health experience preferred).
• Knowledge of commercial insurance, Medicaid, Medicare, and managed care plans.
• Familiarity with prior authorization processes for mental health services.
• Experience working with EHR systems and insurance portals.
• Strong attention to detail and organizational skills.
• Excellent communication and phone etiquette when interacting with insurance representatives.
• Ability to manage multiple tasks and meet deadlines in a fast-paced environment.

Preferred Qualifications

• Experience in behavioral health or mental health clinics.
• Knowledge of CPT codes related to therapy and psychological testing.
• Experience coordinating with providers, intake coordinators, and billing teams.

Skills

• Insurance verification
• Prior authorization management
• Medical billing knowledge
• Documentation accuracy
• Problem solving and follow-up
• Time management

Benefits

• Competitive salary
• Professional development opportunities

Job Type: Full-time

Work Location: In person