About UsHappy Health is revolutionizing sleep medicine delivery through our comprehensive telehealth platform. We've eliminated the traditional barriers to sleep care – no more waiting months for appointments or spending uncomfortable nights in sleep labs. Our patients receive FDA-cleared home sleep testing via Happy Ring, connect with board-certified sleep specialists, and when required, begin evidence-based treatment within just 5 days. Ongoing physiological data monitoring with the Happy Ring enables real-time condition management, combination therapies, and drives measurable outcomes. Happy Ring represents the future of sleep diagnostics: an FDA-cleared medical device integrating advanced biometric sensors with AI-powered analysis to deliver highly accurate diagnostics and longitudinal management at home. For sleep medicine physicians, this means you'll have access to high-quality diagnostic data that empowers you to make confident clinical decisions for your patients, and integrate multimodal treatments that focus on root-cause solutions. Position SummaryWe are a growing Sleep Medicine practice seeking a detail-oriented Verification of Benefits & Authorization Specialist to join our team remotely. In this role, you'll serve as a critical link between our patients, providers, and insurance payers — verifying coverage, securing prior authorizations, and ensuring patients receive timely care without avoidable billing surprises or claim denials.The ideal candidate thrives on accuracy, knows their way around payer portals, and can juggle multiple authorization requests while keeping providers and patients informed every step of the way.Key Responsibilities:Verify patient insurance eligibility and benefits (in-network and out-of-network) prior to scheduled appointments, procedures, and services via payer portals, clearinghouses, and phoneObtain, track, and follow up on prior authorizations and retrospective authorizations for office visits, diagnostic testing, and proceduresAccurately document benefit details, authorization numbers, effective dates, and payer requirements in the practice management system / EHRCalculate patient financial responsibility (copays, coinsurance, deductibles) to front-office staff and patientsIdentify authorization requirements by payer and CPT code, and flag services at risk of denial before they are renderedMonitor pending authorizations and proactively escalate delays that could impact patient care or schedulingCollaborate with providers, clinical staff, schedulers, and billing to resolve coverage issues and reduce claim denialsRespond to authorization-related denials by gathering documentation and initiating appeals or retro-authorizations when appropriateStay current on payer policy changes, medical necessity criteria, and authorization workflowsMaintain compliance with HIPAA and all applicable privacy and security standardsRequired QualificationsHigh school diploma or equivalentMinimum of four (4) years of experience in insurance verification, prior authorization, retrospective authorizations or medical billing in a physician practice or outpatient settingWorking knowledge of commercial insurance, Medicare, and Medicaid plans, including HMO/PPO structures and authorization processesFamiliarity with CPT, ICD-10, and HCPCS coding as it relates to eligibility and authorizationExperience using payer portals (e.g., Availity) and practice management / EHR systemsStrong attention to detail, organization, and follow-throughExcellent written and verbal communication skillsAbility to work independently in a remote environment with reliable high-speed internet and a private, HIPAA-compliant workspacePreferred QualificationsBilingual (English/Spanish) Work Environment:The team is remote, with a physical office in Austin, TX. Direct peers are distributed throughout the continental US. This role is expected to operate with a high degree of autonomy and leadership in a distributed environment.Benefits:100% premium coverage for employee's Health, Dental, and Vision Insurance. 50% premium coverage for dependents.401k platformWFH Stipend
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