Benefits Verification and Auth Specialist

Prompt

6d•Hybrid

About The Position

Prompt is revolutionizing healthcare by delivering highly automated and modern software to rehab therapy businesses, their teams, and the patients they serve. As the fastest-growing company in the therapy EMR space, Prompt is setting a new standard in healthcare technology. We're tackling some of the healthcare industry’s most persistent problems with a team of exceptionally talented individuals passionate about creating a positive impact. At Prompt, we don’t just digitize healthcare—we transform it. From improving patient care to reducing environmental waste, our work supports better outcomes at scale. The BV&A Specialist is responsible for verifying patient insurance eligibility and benefits, obtaining necessary authorizations, and communicating requirements to providers. This role is essential to ensuring a smooth revenue cycle, preventing claim denials, and enhancing the overall patient financial journey.

Requirements

High school diploma or equivalent (Associate or Bachelor’s degree preferred).
1–2 years of experience in benefit verification, medical insurance, or prior authorization.
Strong knowledge of commercial and government payers, insurance policies, and healthcare terminology.
Excellent attention to detail and organizational skills.
Strong communication skills with ability to work across patients, providers, and payers.
Experience with RCM systems and EMRs
Familiarity with payer authorization portals and workflows.
Knowledge of denial management and insurance appeal processes.

Responsibilities

Verify patient insurance coverage, eligibility, and benefits prior to services.
Determine patient responsibility for copays, deductibles, and coinsurance.
Obtain required prior authorizations from payers for services, procedures, or medications.
Document benefit verification and authorization details accurately in the system.
Collaborate with scheduling, billing, and AR teams to ensure accurate workflows.
Communicate clearly, providers, and payers regarding authorization status.
Monitor and track pending authorizations; follow up to prevent delays.
Identify trends in benefit issues or authorization delays and escalate as needed.
Support denial prevention efforts by ensuring all payer requirements are met upfront.