Verification of Benefits & Authorization Specialist
TLDR
Secure prior authorizations through payer portals, document coverage in the EHR, and reduce claim denials across sleep medicine services.
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 escalate 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
Preferred Qualifications
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.
Benefits
Education Stipend
401k platform
Health Insurance
100% premium coverage for employee's Health, Dental, and Vision Insurance. 50% premium coverage for dependents.
Home Office Stipend
WFH Stipend
Remote-Friendly
The team is remote, with a physical office in Austin, TX.
Happy Health is transforming sleep medicine delivery with its telehealth platform that provides FDA-cleared home sleep testing via Happy Ring. Patients can connect with board-certified sleep specialists and access evidence-based treatment quickly, all while benefiting from advanced biometric monitoring and AI-powered diagnostics that enhance real-time condition management.