Benefits Verification and Auth Specialist

Position Summary

The BV&A Specialist is responsible for verifying patient insurance eligibility and benefits, obtaining necessary authorizations, and communicating requirements to providers.

This role is essential to ensuring a smooth revenue cycle, preventing claim denials, and enhancing the overall patient financial journey.

Key Responsibilities

• Verify patient insurance coverage, eligibility, and benefits prior to services.
• Determine patient responsibility for copays, deductibles, and coinsurance.
• Obtain required prior authorizations from payers for services, procedures, or medications.
• Document benefit verification and authorization details accurately in the system.
• Collaborate with scheduling, billing, and AR teams to ensure accurate workflows.
• Communicate clearly, providers, and payers regarding authorization status.
• Monitor and track pending authorizations; follow up to prevent delays.
• Identify trends in benefit issues or authorization delays and escalate as needed.
• Support denial prevention efforts by ensuring all payer requirements are met upfront.
• Minimum Requirements
• 1–2 years of experience in benefit verification, medical insurance, or prior authorization.
• Strong knowledge of commercial and government payers, insurance policies, and healthcare terminology.
• Excellent attention to detail and organizational skills.
• Strong communication skills with ability to work across patients, providers, and payers.
• Experience with RCM systems and EMRs.
• Familiarity with payer authorization portals and workflows.
• Knowledge of denial management and insurance appeal processes.

Perks - What you can expect

• Competitive salaries
• Remote/hybrid environment
• Potential equity compensation for outstanding performance
• Flexible PTO
• Company-wide sponsored lunches
• Company paid disability and life insurance benefits
• Company paid family and medical leave
• Medical, dental, and vision insurance benefits
• Discounted pet insurance
• FSA/DCA and commuter benefits
• Complimentary subscription to digital fitness classes and wellness content
• Recovery suite at HQ – includes a cold plunge, sauna, and shower

Prompt Therapy Solutions, Inc is an equal opportunity employer, indiscriminate of race, color, religion, ethnicity, ancestry, national origin, sex, gender, gender identity, sexual orientation, age, marital status, veteran status, disability, medical condition, or any other protected characteristic.

We celebrate diversity and are committed to creating an inclusive environment for all employees.

Prompt Therapy Solutions, Inc is an E-Verify Employer.

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