Insurance Authorization Specialist

Summary

Join MeBe Family, a provider of evidence-based therapies for children with special needs, as an Insurance & Authorizations Specialist! You will be a key player in ensuring our clinicians have the necessary approvals to serve patients, working closely with the billing and contracting departments. This role involves managing authorization requests, using our EMR (CentralReach), and communicating effectively with clinicians and insurance providers. You'll need at least 4 years of relevant experience and proficiency in various software programs. MeBe offers competitive pay, comprehensive benefits, and a supportive work environment.

Requirements

• Minimum of 4 years of remote clerical/administrative working experience in the medical/behavioral health field
• Minimum of 4 years experience with the verification of benefits and prior authorization processes
• Must have worked with at least one of three disciplines in the past; outpatient Speech, Occupational, and/or Applied Behavior Analysis therapies
• Used Central Reach as an Insurance Authorization or comparable solution in an authorization role
• Advanced understanding of Google Suites, Microsoft Word, Excel, IOS and email
• Dedicated HIPAA compliant workspace with minimal distractions
• Strong verbal and written communication skills
• Located in San Diego or in the Pacific Standard Time zone
• Have a dedicated HIPAA compliant workspace with minimal distractions, required
• Able to maintain a reliable home internet connection, required
• Dependable and detail oriented – This is a remote hourly role. It is expected that the ideal candidate is able to perform the assigned duties within the outlined working hours upon hire
• Team player- works efficiently between Family Success Team, Clinicians, and Authorization Coordinator

Responsibilities

• Directly manage authorization requests for Applied Behavior Analysis, Speech Therapy, and Occupational Therapy services
• Enter authorizations into our EMR (CentralReach)
• Work cohesively with local clinicians & Family Success team members to ensure approvals are processed in a timely manner during onboarding and re-authorization periods
• Effectively communicate benefit and authorization information between clinicians and the Family Success department
• Full ownership of the medical records requests when received from Doctor’s offices or Insurance providers
• Ensure that department resources are updated daily/weekly with upcoming authorization expirations and treatment report submissions
• Oversee biweekly eligibility reports
• Accurately identify and correct problems related to eligibility and authorizations
• Provides concierge-level customer service while interacting with insurance company representatives
• Oversee and perform various clerical and administrative tasks related to authorizations and associated issues that require initiative and independent judgment
• Respond to day-to-day operational requirements in a professional and timely manner
• Other duties as assigned

Preferred Qualifications

Monday.com is a plus

Benefits

• Industry Benchmarked, competitive pay based on location and experience
• $27 - $32 per hour
• Twenty nine paid days off
• Medical, Vision, Dental- Anthem Insurance; 80% Employee, 50% Dependents
• Life, AD&D, Accident, Hospital Indemnity, Short Term Disability, and Critical Illness Insurance
• Invest in your mental health with access to free mental health sessions
• Protect your pet with discounted pet insurance
• Secure your future with our 401k program
• Tuition discounts available to all employees through our University Partnerships
• Expansive treatment spaces
• Options for positions in variety of settings: clinic; in-home
• Scheduling department handles reschedules, cancellations and permanent changes to schedules
• Work tools provided
• Company sponsored, fun events for everyone