Behavioral Health Authorization and Verification Specialist

📋 Description

• • Join Silna Health, a pioneering health technology company dedicated to revolutionizing how specialty healthcare providers manage patient financial clearance. We are at the forefront of streamlining eligibility and benefit checks, as well as prior authorizations, enabling providers to dedicate more time to delivering exceptional patient care. Based in the vibrant landscape of New York City, our reach extends across the nation, serving a diverse clientele.
• • We are actively seeking an enterprising and highly skilled Prior Authorization and Benefits Verification Specialist to become an integral part of our remote team. In this pivotal role, you will serve as a direct liaison between our valued customers – specifically ABA (Autism), Mental Health, IOP, and Psych Testing providers – and the complex world of insurance authorizations and benefit verifications. Your primary responsibility will be to expertly navigate these administrative tasks on their behalf, ensuring seamless patient access to necessary care.
• • This position offers a unique and exciting opportunity that extends beyond traditional administrative duties. You will collaborate closely with our innovative Silna Product team, contributing your deep domain expertise to the automation of critical verification and authorization processes. Your insights will be instrumental in shaping the future of our technology, making these essential functions more efficient and effective for both providers and patients.
• • Your day-to-day responsibilities will encompass a wide range of critical functions. You will work diligently with behavioral health providers and their dedicated billing teams to meticulously collect accurate patient information. This includes gathering all necessary documentation and details required for successful authorizations and benefit verifications. Furthermore, you will be responsible for clear and timely communication of authorization decisions and any potential issues to the providers.
• • A significant aspect of your role will involve direct engagement with various insurance companies. You will expertly verify patient eligibility and benefits, ensuring a comprehensive understanding of coverage details. Expediently completing prior authorizations will be a key performance indicator, achieved through proficient use of insurance portals and direct communication via phone calls to payors.
• • Proactive follow-up with insurance companies will be essential to ensure timely approval of authorizations. This may involve providing additional supporting documentation or clarifying information as requested by the insurer. Your ability to manage multiple prior authorizations concurrently, while maintaining a high standard of accuracy and efficiency, will be crucial. You will also be instrumental in developing and refining processes to ensure top-tier performance and minimize delays.
• • A deep understanding of specialty-specific workflows within behavioral health is paramount. This includes familiarity with the nuances of creating treatment plans, managing re-authorizations, and addressing any specific requirements unique to ABA, mental health, and psychological testing services.
• • You will have the opportunity to become a recognized subject matter expert in behavioral health prior authorization workflows, particularly as they pertain to large and complex insurance providers. Your knowledge will be invaluable in guiding our strategies and improving our service offerings.
• • Your collaboration with the Silna Product Engineering teams will be a cornerstone of this role. You will share your frontline learnings and insights regarding the benefits verification and prior authorization processes. This direct feedback loop is vital for identifying opportunities and contributing to the automation of these processes, ultimately enhancing our platform's capabilities.
• • Exceptional communication skills are a must, as you will be interacting effectively across multiple stakeholders, including providers, insurance representatives, and internal product teams. Maintaining clear, concise, and professional communication at all times will be essential for success.
• • This is a full-time, remote position requiring a commitment of 40 hours per week. We are looking for an individual who is not only proficient in the technical aspects of the role but also passionate about making a tangible impact on patients' ability to access critical behavioral health services.
• • By joining Silna Health, you are contributing to a mission-driven organization that is making a real difference in the healthcare landscape. Your work will directly impact the lives of individuals and families seeking essential behavioral health support, ensuring they can receive the care they need without undue administrative burden.