Benefits Verification and Auth Specialist

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 - 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.