Requirements: – Proficiency in using medical billing software, insurance verification systems, and electronic health records (EHR) platforms. – Solid understanding of behavioral health coding and billing guidelines (e.g., CPT, HCPCS, ICD-10) and their implications for insurance verification. – Knowledge of insurance payers’ coverage policies, benefit structures, pre-authorization requirements, and claim submission guidelines. – Exceptional attention to detail and organizational skills, with the ability to manage multiple verification requests simultaneously and meet deadlines. – Strong analytical and problem-solving abilities to identify discrepancies or issues in insurance coverage or benefit information. – Excellent written and verbal communication skills, with the ability to convey complex information clearly and professionally to diverse stakeholders. – Demonstrated ability to work independently and collaboratively within a team environment. – Commitment to maintaining confidentiality of sensitive information and adhering to HIPAA regulations.

Responsibilities: – Obtain and verify insurance eligibility and benefits for behavioral health services through direct communication with insurance companies, payers, and other relevant sources. – Review insurance policies and coverage details to determine the scope of benefits, pre-authorization requirements, limitations, and any patient financial responsibilities. – Document and enter accurate insurance benefit information into billing systems or electronic health records (EHR) platforms. – Collaborate with internal teams to ensure timely and efficient pre-authorization of services based on verified benefits and payer requirements. – Communicate benefit information effectively and professionally to internal stakeholders, including clinicians, billing specialists, and front desk staff. – Stay updated on insurance payer policies, coverage changes, and industry best practices related to insurance verification and pre-authorization. – Identify and address discrepancies or issues related to insurance coverage, benefits, or pre-authorization requirements, escalating complex cases to appropriate internal teams. – Maintain comprehensive and accurate documentation of verification activities, interactions, and outcomes in internal systems. – Provide exceptional customer service to internal and external stakeholders, answering inquiries related to insurance benefits and explaining coverage details to patients, as necessary. – Collaborate with cross-functional teams to streamline verification processes, enhance efficiency, and improve the overall revenue cycle management workflow.