Insurance Verification & Authorization Specialist (Behavioral Health)

Location: Fully remote; Eastern Time business hours, with the Eastern Time Zone preferred

Salary: $23–$25 per hour

Company

Clinician-founded pediatric mental health provider delivering virtual and in-person care across Pennsylvania, Virginia, New Jersey, and Maryland.

What you will do

• Verify insurance eligibility, coverage, and behavioral health benefits for new and existing patients.
• Review patient inquiries to confirm age, location, insurance participation, and service eligibility.
• Identify payer-specific requirements and complexities involving third-party behavioral health administrators.
• Obtain, submit, and track prior authorizations and referrals.
• Communicate with insurance carriers about coverage discrepancies and explain copays, coinsurance, deductibles, and other patient financial responsibilities.
• Manage high-volume requests in ticketing and EHR systems while maintaining accurate documentation and coordinating with internal teams.

Requirements

• Experience with healthcare insurance verification, eligibility, benefits determination, prior authorizations, or referrals.
• Strong understanding of insurance terminology, including copays, coinsurance, deductibles, and out-of-pocket costs.
• Exceptional attention to detail and the ability to manage high-volume workflows and investigate coverage discrepancies.
• Strong communication, organizational, and problem-solving skills when working with patients, insurance carriers, and internal teams.
• Ability to maintain patient confidentiality and comply with HIPAA requirements.

Nice to have

• Experience with behavioral health insurance benefits, prior authorizations, or specialty healthcare.
• Familiarity with Athenahealth, other EHR systems, and insurance portals.

Culture & Benefits

• Full-time hourly, non-exempt employment with benefits eligibility.
• Remote work arrangement aligned with Eastern Time business hours.
• Collaborative, supportive, and inclusive environment focused on pediatric mental health care.
• Opportunity to contribute to a whole-child approach addressing the interaction of the brain, body, and behavior.