Behavioral Health Authorization and Verification Specialist

Silna Health

13d•Remote

About The Position

Silna Health (silnahealth.com) is a health technology company that handles eligibility & benefit checks and prior authorizations for specialty healthcare providers. Our mission is to streamline how providers financially clear patients for care, so providers can spend more time delivering exceptional care. We are based in New York City and work with customers across the country. Silna Health is looking for an enterprising prior authorization and benefits verifications expert to work closely with our customers - ABA (Autism), Mental Health, IOP, and Psych Testing providers - and complete these administrative tasks on their behalf. This is a unique role, as you will also be working closely with the Silna Product team to automate parts of the verification and authorization processes.

Requirements

The ideal candidate will have a strong understanding of insurance policies and billing processes in ABA, Mental Health, Psych, etc.
3+ years of experience completing prior authorizations for behavioral health services specifically (not medications
Strong understanding of benefits including deductibles, co-insurance, out of pocket and benefits exclusions
Have familiarity with payor portals and experience calling payors
Have a strong work ethic: operate with urgency, work independently, be highly organized, detailed oriented and multi-task effectively

Nice To Haves

Be familiar with providers software, including Electronic Medical Record Systems (EMR/EHR) like CentralReach and Rethink

Responsibilities

Work closely with behavioral health providers and their billing team to collect accurate patient information and communicate authorization decisions
Work with insurers to verify patient eligibility and benefits, and expediently complete prior authorizations using insurance portals or calling insurers directly. Ensure authorization is approved in a timeline manner by following up with insurers and providing additional information
Be responsible for handling multiple prior authorizations simultaneously and create process to ensure top of the line performance
Understand specialty-specific workflows, including creating treatment plans, re-authorizations, etc.
Become a subject matter expert in behavioral health prior authorization workflows for large insurers
Work closely with Silna Product/Engineering teams to share learnings about the benefits verification and prior authorization processes to help automate parts of them
Communicate effectively across multiple stakeholders
Be willing to work 40 hours per week