Verification of Benefits & Authorization Specialist

Happy Health; United States; Remote; USD 25,000 - 30,000; Full time

Benefits offered by this job

Full health/dental/vision for employee

Dependent coverage 50%

WFH stipend

401k plan

Job summary

Happy Health is a growing Sleep Medicine practice seeking a detail-oriented Verification of Benefits & Authorization Specialist to join our remote team. You will verify coverage, secure prior authorizations, and ensure patients receive timely care without billing surprises or denials.

The ideal candidate thrives on accuracy, navigates payer portals, and can manage multiple authorization requests while keeping providers and patients informed at every step.

Qualifications

• High school diploma or equivalent.
• 4+ years in insurance verification, prior authorization, retrospective authorizations or medical billing.
• Familiar with CPT, ICD-10, HCPCS coding and payer portals (e.g., Availity).
• Experience in a physician practice or outpatient setting and remote work capability.

Responsibilities

• Verify insurance eligibility and benefits (in-network and out-of-network) via payer portals and phone.
• Obtain, track, and follow up on prior and retrospective authorizations for visits, tests, procedures.
• Document benefit details, authorization numbers, dates, and payer requirements in the EHR.
• Calculate patient financial responsibility and communicate with front desk and patients.
• Identify authorization requirements by payer and CPT code to prevent denials.
• Monitor pending authorizations and escalate delays affecting care or scheduling.
• Collaborate with providers, schedulers, and billing to reduce claim denials.
• Respond to denials with documentation and potential appeals.
• Stay current on payer policy changes and HIPAA/compliance standards.
• Maintain HIPAA-compliant remote workspace and data security.

Skills

Attention to detail

Organization

Communication

Independent work

Remote work capability

Education

High school diploma or equivalent

Tools

Availity payer portal

Practice management / EHR systems

Job description

About Us

Happy Health is revolutionizing sleep medicine delivery through our comprehensive telehealth platform. We've eliminated the traditional barriers to sleep care - no more waiting months for appointments or spending uncomfortable nights in sleep labs. Our patients receive FDA-cleared home sleep testing via Happy Ring, connect with board-certified sleep specialists, and when required, begin evidence-based treatment within just 5 days. Ongoing physiological data monitoring with the Happy Ring enables real-time condition management, combination therapies, and drives measurable outcomes.

Happy Ring

represents the future of sleep diagnostics: an FDA-cleared medical device integrating advanced biometric sensors with AI-powered analysis to deliver highly accurate diagnostics and longitudinal management at home. For sleep medicine physicians, this means you'll have access to high-quality diagnostic data that empowers you to make confident clinical decisions for your patients, and integrate multimodal treatments that focus on root-cause solutions.

Position Summary

We are a growing Sleep Medicine practice seeking a detail-oriented Verification of Benefits & Authorization Specialist to join our team remotely. In this role, you'll serve as a critical link between our patients, providers, and insurance payers - verifying coverage, securing prior authorizations, and ensuring patients receive timely care without avoidable billing surprises or claim denials.

The ideal candidate thrives on accuracy, knows their way around payer portals, and can juggle multiple authorization requests while keeping providers and patients informed every step of the way.

Key Responsibilities:

• Verify patient insurance eligibility and benefits (in-network and out-of-network) prior to scheduled appointments, procedures, and services via payer portals, clearinghouses, and phone
• Obtain, track, and follow up on prior authorizations and retrospective authorizations for office visits, diagnostic testing, and procedures
• Accurately document benefit details, authorization numbers, effective dates, and payer requirements in the practice management system / EHR
• Calculate patient financial responsibility (copays, coinsurance, deductibles) to front-office staff and patients
• Identify authorization requirements by payer and CPT code, and flag services at risk of denial before they are rendered
• Monitor pending authorizations and proactively escalation delays that could impact patient care or scheduling
• Collaborate with providers, clinical staff, schedulers, and billing to resolve coverage issues and reduce claim denials
• Respond to authorization-related denials by gathering documentation and initiating appeals or retro-authorizations when appropriate
• Stay current on payer policy changes, medical necessity criteria, and authorization workflows
• Maintain compliance with HIPAA and all applicable privacy and security standards

Required Qualifications

• High school diploma or equivalent
• Minimum of four (4) years of experience in insurance verification, prior authorization, retrospective authorizations or medical billing in a physician practice or outpatient setting
• Working knowledge of commercial insurance, Medicare, and Medicaid plans, including HMO/PPO structures and authorization processes
• Familiarity with CPT, ICD-10, and HCPCS coding as it relates to eligibility and authorization
• Experience using payer portals (e.g., Availity) and practice management / EHR systems
• Strong attention to detail, organization, and follow-through
• Excellent written and verbal communication skills
• Ability to work independently in a remote environment with reliable high-speed internet and a private, HIPAA-compliant workspace

Preferred Qualifications

• Bilingual (English/Spanish)

$18 - $22 an hour

Work Environment:

The team is remote, with a physical office in Austin, TX. Direct peers are distributed throughout the continental US. This role is expected to operate with a high degree of autonomy and leadership in a distributed environment.

Benefits:

• 100% premium coverage for employee's Health, Dental, and Vision Insurance. 50% premium coverage for dependents.
• 401k platform
• WFH Stipend

Happy Health is an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.