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Benefits Verification and Auth Specialist

Prompt
2 months ago
Full-time
Remote
Worldwide
Remote Other
Job Title: Benefits Verification and Auth Specialist

Company Overview:

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.

Why work for Prompt?

- BIG Challenges: Here at Prompt, we are solving complex and unique problems that have plagued the healthcare industry since the dawn of time.

- Talented People: Prompt didn't happen by chance, it's a team of incredibly talented and proven individuals who all made their mark before joining forces to build the greatest software on the planet for rehab therapists.

- Healthy Approach: This isn't an investment bank, we work long hours when it's needed, but at Prompt you own your workload and the entire organization takes a liking to smart work (over hard work).

- Positive Impact: Prompt helps outpatient rehab organizations treat more patients and deliver better care with less environmental waste. That means less surgery and less narcotic-based pain treatment, all while turning a paper-heavy industry digital. We aren't enthralled with patting ourselves on the back everyday, but it does feel good :)

Position Summary

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.

Key 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.


Minimum 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, insu