Authorization Specialist
Job Description
As we grow our health plan partnerships and clinical volume, the Authorization Specialist will play an important role to ensure insurance payer authorizations and insurance eligibility are in place – a key component to access clinical care, and successfully bill payers.
This role will be responsible for designing and implementing new workflows and processes for authorization and insurance verification, ensuring proactively and accurately coordinating and obtaining information required in the pre-access financial clearance process. An enthusiastic, self-motivated and detail-oriented professionals with a desire for a fast-paced, high-growth environment would do well in this role.
How your skills and passion will come to life at Headspace Health
- Work with RCM leadership on designing and implementing authorization, insurance verification, and other financial clearance workflows, based on industry best practice
- Independently research payer specific payer requirements and suggest changes to new and existing workflows to accommodate payer and client specific requirements
- Proactively coordinate all information required of the authorization process, ensuring complete, accurate and timely information collection and entry
- Efficiently obtain and track authorizations approvals from payers by phone, fax and electronic data exchange
- Accurately transcribe and verify fax authorizations to create eligibility files and electronic medical records
- Support the authorizations to billing pathway in submitting claims when needed
- Effectively organize and manage workload to ensure timely completion
- Communicate responsively and positively with external partners and internal teammates
- Collaborate w/ clinical operations team as needed in support of access to care, and successful claims submission
- Meet weekly with manager and team to collaborate on individual and team objectives and outcomes
- Applicants with disabilities may be entitled to reasonable accommodation under the terms of the Americans with Disabilities Act and certain state or local laws. A reasonable accommodation is a change in the way things are normally done which will ensure an equal employment opportunity without imposing undue hardship on Headspace Health. Please inform our Talent team if you need any assistance completing any forms or to otherwise participate in the application process.
Qualification and Skills Needed
- BA/BS in Social Sciences or related field; or equivalent work experience in a health care environment
- 3-5 year of experience in a healthcare, medical, or insurance payer setting preferred
- Proficient working knowledge of G-Suite and organizational skills required
- Strong organizational, time management, and problem-solving skills
- Strong attention to detail, fast learner
- Strong interpersonal and written communication skills
- Comfortable with ambiguity and excelling in a scaling start-up environment
- Self-directed & motivated
- Genuine connection to Ginger’s mission and behavioral health
