Verification of Benefits Specialist

Remedy Therapy is currently seeking dedicated and compassionate individuals to join our Team. As a leading provider of in-patient services, Remedy specializes in both Behavioral Health, including Substance Use Disorder (SUD) treatment, and Mental Health care, with a focus on Eating Disorders. All our Team Members play vital roles in supporting individuals and families during some of their most critical moments, guiding them through the care process with empathy and professionalism. If you're passionate about making a difference and thrive in a fast-paced, mission-driven environment, we invite you to apply.

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Position Purpose:

The Verification of Benefits (VOB) Specialist is responsible for conducting comprehensive insurance eligibility and benefit verification for prospective and current clients seeking treatment for Substance Use Disorders (SUD), Mental Health Disorders, and Eating Disorders (ED). This role serves as a critical financial and operational liaison between the admissions team, utilization review department, billing office, and insurance payers to ensure accurate benefit determination, financial transparency, and timely authorization coordination prior to admission. The VOB Specialist plays a vital role in reducing denials, improving reimbursement accuracy, minimizing financial risk, and ensuring clients receive clear and accurate financial information before entering treatment. This position requires advanced understanding of behavioral health insurance benefits, payer guidelines, medical necessity requirements, and authorization processes specific to detoxification, residential, PHP, IOP, outpatient, and eating disorder treatment services.

Position Specific Competencies:

1. Advanced understanding of insurance terminology and benefit structures, including deductibles, out-of-pocket maximums, copayments, coinsurance, and coverage limitations, with the ability to clearly communicate financial responsibility information to clients and internal stakeholders. 2. Proficiency in payer portal navigation and telephonic insurance verification processes, including the ability to efficiently access online eligibility systems, interpret benefit information, and ask targeted, payer-specific questions to obtain accurate authorization and coverage details. 3. Strong ability to prioritize and triage high-volume Verification of Benefits (VOB) requests in a fast-paced admissions environment, ensuring timely completion of urgent cases and admissions-related deadlines. 4. Exceptional attention to detail with a high degree of accuracy in documentation, data entry, insurance verification recording, and payer communication tracking to support compliance and denial prevention efforts. 5. Comprehensive knowledge of insurance plan structures and funding types, including Commercial plans, Medicaid Managed Care, Marketplace/Exchange plans, Medicare Advantage, Medicare Supplement plans, and other government-sponsored or third-party payer programs. 6. Know and maintain professional communication skills: verbal, written, and non-verbal communication 7. Understand and maintains the highest level of HIPAA (Health Insurance Portability and Accountability) standards

Position Duties, Responsibilities, and Tasks:

1.

Core:

a. Contact insurance carriers via phone and/or online portals to verify active coverage prior to client admission. b. Confirm eating disorder and/or substance use benefits, including in-network vs. out-of-network status. c. Obtain deductible, copay, coinsurance, and out-of-pocket maximum details. d. Verify authorization requirements, referral needs, and session/visit limits. e. Confirm telehealth coverage where applicable. f. Provide estimated cost-of-care breakdowns based on verified benefits. g. Coordinate with the intake team to ensure VOB is completed before scheduled admission. h. Obtain and verify client insurance cards, policy numbers, and subscriber information. i. Accurately document all VOB results in the EHR and/or billing system. j. Maintain up-to-date records of insurance contacts, portal logins, and payer-specific requirements. k. Log all payer communications with dates, reference numbers, and representative names. l. Identify and escalate coverage gaps, inactive policies, or high financial responsibility situations. m. Assist the billing team with denial research related to eligibility and authorization issues. n. Handle all protected health information (PHI) in accordance with HIPAA privacy and security regulations. 2.

Administrative:

a) Works well independently and has strong operational skills b) Excels at customer service and has strong interpersonal skills c) Strong organizational and time management skills d) Demonstrates a positive attitude and maintains a positive corporate culture e) Communicates effectively and has strong verbal, non-verbal, and written communication skills f) Develops strong relationships with coworkers and other stakeholders g) Learns quickly and has strong problem-solving and critical-thinking skills h) Willingness to continually self-educate and grow professionally i) Prompt and regular attendance j) Assist and perform additional duties as asked or assigned

Qualifications/Position Requirements:

1.

Education:

No specific education requirement.

Associate degree in Healthcare Administration, Medical Billing & Coding, Business Administration, or related field preferred. 2.

Experience:

Minimum of 1-2 years of insurance verification, admissions, healthcare billing, or revenue cycle experience required. Behavioral health, eating disorder, psychiatric, or substance use treatment experience strongly preferred. Experience working with commercial insurance plans and behavioral health payers preferred.

Experience with:

Detox, Residential Treatment, PHP/IOP, Eating Disorder Programs preferred. 3.

Certification/Licensure:

CPR/First Aid Certification within 6 months of hire. Certified Revenue Cycle Representative, Certified Professional Biller, or Behavioral Health Revenue Cycle Certification/Training preferred. 4. Training and Knowledge Required at

Time of Hire:

Understanding of health insurance terminology and medical necessity criteria. Knowledge of major behavioral health payers. Knowledge of eating disorder-specific authorization challenges preferred. Proficiency in Electronic Health Records, Insurance portals, Microsoft Office Suite, and CRM/intake platforms. Excellent communication, organizational and multitasking abilities with attention to detail. 5.

Age Specific Individuals Served/Responsibility:

Adults (18+ years) 6.

Security Measures and Clearance:

Approved AHCA Level 2 screening required. Additionally, may require a local background check.

Pay:

$18.00 - $22.00 per hour

Benefits:

401(k) Dental insurance Health insurance Life insurance Paid time off Vision insurance Application Question(s): What systems have you used in the past to verify insurance?

Experience:

Salesforce:

1 year (Preferred)

Work Location:

In person