Opal Autism Centers Hiring for Insurance Eligibility & Authorization Specialist (ABA) Job at Sarasota, FL Full Time

About us

We are innovative, agile and fast-paced.

Our work environment includes:

• Growth opportunities
• Work-from-home days
• On-the-job training

Opal Autism Centers has an immediate opening for an Eligibility and Authorization Specialist. We are opening centers across the U.S. and are excitedly growing our team! *Who we are: * We are a child-centric organization headed by operational and clinical experts that genuinely love the science of behavior change and the impact it has on our clients and their families. Innovative and fun are the words that come to mind when we think of the teams we’ve built! We are determined to change the industry standard for ABA. By targeting underserved regions, military communities, and areas where it can take over a year to access services, we have been successfully able to extend our reach to countless children in need of ABA. We carry smiles on our faces, compassion in our hearts, and embody an unparalleled fierce dedication to the children we work with and advocate for daily! We invite you to find YOUR purpose with Opal! Have fun with us while helping to provide high-quality, compassionate, value-based care to our clients and their families; or by supporting our clinical teams that do! We have a place for you. *What we do: * We use positive reinforcement and play, keeping children engaged and having fun while providing high-quality evidence-based ABA therapy. We provide care focused on individuality. We pride ourselves in serving the autism community through compassion-led, science backed, customized services, tailored to each little learner. We aim to expand on clients’ interests and preferences, while teaching them important skills that will help them navigate daily life, communicate and interact with the world, and improve their quality of life. Basically, we change little lives in big ways! *Work Culture-Opalized: * Opal Autism Centers exists to build and maintain an organizational culture that attracts and engages the most skillful talent in our industry. A fundamental tenant at Opal is to empower and equip our team with world-class systems, resources, mentoring, and coaching to ultimately do their best work in providing life-changing ABA therapy. Our culture of excellence is evidenced in everything that we do. We are committed to mentoring strong industry leaders and individuals who pay it forward in their commitment to our learners and their parents through the exceptional services provided from admissions to graduation of our program. *Who you are: * We are looking for a driven self-starter to join our Revenue Cycle Team. The Insurance Verification and Authorization Specialist supports the billing department in all areas of revenue cycle management including verifying eligibility and benefits, collect and review referrals and pre-authorizations, audit data to ensure claims are clean, ensure the patient’s medical information is accurate and up to date, examine patient information for accuracy and request any missing information, assist providers in developing patient payment plans, assist billing specialists with billing tasks including investigating and appealing denied claims. To succeed in this role, the Insurance Verification and Authorization Specialist  must possess in-depth knowledge of the revenue cycle process and the ability to quickly learn the nuances and codes of ABA/autism billing as well as the various EHR systems and online payer portals used in the ABA industry. The ideal candidate must also be able to demonstrate excellent written and verbal communication skills, as communicating with clients and various insurance agents will form a large part of the job. In this position, you will be responsible for a variety of tasks requiring data analysis, in-depth evaluation, multi-tasking and sound judgment. *What you’ll do: * * Responsible for the timely verification of insurance benefits provided via websites and/or calling the payor. * Obtain precertification and authorizations for services being rendered * Review and resolves prior authorization/precertification/referral issues that are not valid and contacts insurance carriers to verify/validate requirements to ensure accuracy and avoid potential denial. * Identify and forward potential reimbursement problems with the Billing Team. * Initiating benefits verification by reviewing patient data and insurance material, including identifying missing information and following up with points of contact to resolve information gaps * Verifying benefits for each assigned patient case and documenting any requirements for reimbursement including copays, coinsurance, utilization management requirements, qualifications / restrictions, and prior authorization requirements * Process authorizations electronically, utilizing payer portals, fax, or telephone working with the payers to secure authorizations retrospectively and/or requesting single case agreements for out of network patients * Work directly with providers to secure clinical notes and other supporting documentation required to obtain authorizations timely * Identifying clarifying questions to get the best results on the first call * Entering data and notes in an accurate manner * Effectively communicating next steps to team * Following HIPAA regulations when handling client information * Communicating and working effectively with team members * Other duties as assigned *Here are some of our ideas about what the ideal candidate will be all about: * Our ideal candidate is an energetic, outgoing, recent graduate looking to break into the healthcare industry! * You have a passion for excellent customer service and patient experience – telling the story of a business to the community and generating leads, especially through online tools. * You have passions that you’ve built into your studies and your life. You delve deep into your work; you are not one to barely scratch the surface, just enough to check off a box. * You are a fluid writer and an eloquent speaker. Send us a cover letter that showcases your style, future goals, and that does a good job of conveying who you are on both a personal and professional level. * You are looking for a career to excel at because you are a driven person and are tired of simply collecting a paycheck while the hours tick by on the clock. * You are reinforced by beating your own best, having a seat at the table, and offering your brilliant and innovative mind to solve problems and contributing to the company’s overall success. * You are a natural born leader, but you value feedback for growth and can manage expectations well. * You are smart. Quick. Curious. Ambitious. Dedicated. People would describe you as generous and compassionate while also tenacious and ambitious. *If you are interested in this position, please do the following: briefly address our criteria above in a customized cover letter and make the case for yourself. Email us at careers @ opalautism .com *What we offer: * * Paid training * A fun team * Professional development assistance * 401(k) * Dental insurance * Health insurance * Health savings account * Life insurance * Generous paid time off * Vision insurance * Long & short-term disability * Mileage reimbursement * Employee referral bonus * No contractual obligation to stay. Stay because you love us! * Room to grow with our career succession planning Job Type: Full-time, Remote

Job Type: Full-time

Pay: $42,000.00 – $50,000.00 per year

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Application Question(s):

• Tell us about yourself. Please be detailed and not generic or vague. We want to get a feel for who you are as a person. What makes you unique, what makes you sure of your success and abilities, what drives you, what reinforces you?
• What is your favorite part about working with insurance and authorizations?
• What is your salary expectation?
• Have you worked remotely before? Please explain.

Experience:

• Medical office: 1 year (Required)
• Insurance verification and authorizations: 1 year (Preferred)

Work Location: Remote