Authorization Specialist

Summary

Join Grow Therapy as an Authorization Specialist and contribute to our mission of improving mental healthcare accessibility. Initially, you will accurately submit prior authorization requests, track their status, research denied claims, and resolve issues with insurance carriers. You will also ensure data accuracy, collaborate with internal teams, and prioritize workflows. The role requires strong healthcare claims knowledge and at least two years of experience in medical billing or a healthcare setting. Grow Therapy offers a competitive salary, comprehensive health insurance, flexible working hours, flexible time off, and various wellness benefits.

Requirements

• Process-driven: Highly organized, operational thinker, rarely leaving questions unanswered
• Adaptable: You are comfortable in a fast-paced environment, with priorities changing weekly
• Healthcare Experienced: Strong understanding of healthcare claims, plan benefits, and patient responsibilities. At least 2 years of experience in Medical Billing or Healthcare setting
• Team Player: You are collaborative by nature, relish in camaraderie and group wins, and are looked to by colleagues or direct reports as a steadfast partner & source of encouragement

Responsibilities

• Accurately and efficiently submit prior authorization requests to insurance payers based on clinical and administrative requirements
• Regularly track, follow up, and update the status of submitted authorizations to ensure timely approvals
• Research and find solutions to denied claims
• Complete outbound calls to insurance carrier supervisors to investigate denial reasons
• Resubmit claims with errors, utilizing knowledge of CMS 1500 forms and a broad understanding of data, coding, and policy errors
• Ensures compliance by staying current with payer-specific authorization guidelines and maintains compliance with HIPAA and company policies
• Draft appeals for relevant claim denials, adhering to medical policies for all insurance carriers
• Ensure patient data in all systems is accurate and up-to-date, reaching out to the appropriate contacts to resolve any inconsistencies
• Collaborate with internal teams to gather required documentation and clarify payer requirements as needed
• Prioritize workflows based on the age of claims

Benefits

• Comprehensive health insurance plans, including dental and vision
• Flexible working hours
• Flexible Time Off
• Company-wide winter break
• Mental health mornings (2 hours each week)
• Wellness Stipend
• In-office meals and snacks
• Continuous learning opportunities
• Competitive salary