Description:
We are seeking a detail-oriented VOB & Authorization Specialist with experience in psychiatric and behavioral health services. The ideal candidate will be responsible for insurance eligibility verification, benefit analysis, prior authorizations, and ensuring clean claim submission for mental health services.
Key Responsibilities
- Perform insurance eligibility and benefits verification (VOB) for psychiatric and behavioral health services.
- Verify coverage for CPT codes such as psychotherapy, psychiatric evaluations, medication management, Spravato, and related services.
- Obtain and track prior authorizations for mental health services.
Confirm:
- Deductibles, copays, coinsurance
- Annual deductibles, out of pocket
- In-network benefits
- Out-of-network benefits
- Telehealth coverage
- Authorization requirements
- Document verification details accurately in the billing system.
- Communicate coverage details to front desk and billing team.
- Follow up with insurance companies regarding authorization status.
- Resolve COB (Coordination of Benefits) issues.
- Work closely with providers and scheduling team to prevent denials.
Required Qualifications
- Minimum 1–2 years’ experience preferably in Behavioral Health billing
- Strong knowledge of mental health CPT codes
- Experience handling prior authorizations
- Familiarity with Medicaid, Medicare Advantage, and commercial plans
- Experience with EHR/PM systems (Tebra, Practice Fusion, etc.)
- Strong communication and documentation skills