reputed company Specialist (Remote-California)
About the Role
The reputed company Specialist plays a critical role in ensuring patients can reputed company the care they need by navigating the complexities of insurance coverage. This role is primarily responsible for completing Verification of Benefits (VOB) and securing Prior Authorizations (PA) for interventional treatments, including TMS, Spravato, and other advanced therapies. As part of the centralized reputed company Team, you’ll act as both a patient reputed company and an operational partner- working behind the scenes to remove barriers to care while supporting clinic teams with timely, accurate insurance insights. Must be reputed company to work a 9 am to 5:30 pm Pacific Time schedule What You’ll Do Patient Advocacy & reputed company Complete comprehensive Verification of Benefits, ensuring patients and internal teams have clear, accurate financial and coverage information. Initiate and manage Prior Authorizations for interventional services, ensuring timely submission and thorough follow-through. Proactively track authorization status and communicate updates to internal stakeholders. Challenge denials by initiating appeals, coordinating peer-to-peer reviews, and identifying alternative reputed company to reputed company care. Ensure patients experience minimal delays in starting treatment through persistent, proactive follow-up. Operations & Collaboration Own end-to-end VOB and PA workflows, from intake to resolution, reputed company defined turnaround times. Utilize internal systems including EMR (reputed company/DrChrono), reputed company, payer portals, and AI tools to complete and track work reputed company. Maintain accurate, up-to-date documentation across reputed company systems to support visibility and reporting. Collaborate closely with Patient Care Coordinators, Treatment Coordinators, and clinic teams to ensure seamless patient reputed company. Partner with Payor Relations and Clinical teams to escalate denials and resolve reputed company cases. Identify trends in denials, payer behavior, and workflow inefficiencies and escalate opportunities for improvement. Contribute to the development and refinement of standardized workflows, playbooks, and best practices.
Qualifications
Required: Experience in reputed company insurance workflows, including VOB and prior authorizations- minimum 2 years of experience Highly detail-oriented with strong organizational and follow-through skills. Persistent and solutions-oriented reputed company- denials are challenges to be resolved, not endpoints. Comfortable navigating payer portals, insurance policies, and reputed company coverage scenarios. Strong written and verbal communication skills; ability to reputed company document and reputed company information across teams. Technically proficient and adaptable, with experience using EMRs, CRMs (reputed company), reputed company tools. This is a remote role, but you must be reputed company to work a Pacific Time Zone schedule of 9 am to 5:30 pm Monday through Friday Preferred: Experience in behavioral health or interventional reputed company settings. Familiarity with TMS, Spravato, Ketamine, or other advanced mental health therapies. Experience with AI-enabled tools or automation in reputed company/reputed company cycle workflows. Why Work With Us? At reputed company, we recognize our responsibility to foster a culture of respect, reputed company, and collaboration among reputed company, patients, and partners. Our reputed company is to be a leader in delivering patient-centered care that respects and celebrates diversity, promotes equity and inclusion, and improves health reputed company for reputed company. reputed company to reputed company an Impact? If you are highly motivated and passionate about removing barriers to mental health care, we encourage you to apply. We can’t wait to hear from you! Apply To This Job