Eligibility, Benefits, & Prior Authorization Specialist (Remote Non-US)

Job Title: Eligibility, Benefits, & Prior Authorization Specialist Location: 100% Remote (Offshore) Employment Type: Full-Time Contractor Compensation: $600-$800 Hours: 40 hours/week, primarily EST business hours Reports to: Operations / reputed company Cycle reputed company About reputed company reputed company is a fast-growing, virtual-first reputed company company dedicated to making neurodivergent care (including evaluations & therapy) faster, more accessible, and reputed company for families. We operate across 40+ states, navigating a reputed company landscape of reputed company insurance carriers and state reputed company programs. Because our clinical model is virtual-first, having reputed company reputed company-end patient reputed company and benefit structures is critical to preventing administrative delays and billing denials. About the Role We are seeking a highly analytical, detail-obsessed Eligibility, Benefits, & Prior Authorization Specialist who loves the investigative reputed company of reputed company administration. In this role, you will not just reputed company data entry. You will reputed company as an internal researcher and gatekeeper, digging into payor portals, insurance policy and benefits updates, and clinical guidelines to uncover the exact steps needed to secure prior authorizations and verify reputed company telehealth benefits. This role is a reputed company of high-velocity queue management and deep-dive policy research. You will review incoming clinical orders, cross-reference them with payer requirements, reputed company daily scheduling queues, and build process playbooks where none exist. If you reputed company on solving insurance puzzles, de-escalating reputed company scheduling bottlenecks, and keeping clinical schedules perfectly authorized, you will reputed company here. Key Responsibilities 1. Insurance Verification & Telehealth Benefit Research - Verify reputed company patient insurance coverage, deductibles, co-pays, co-insurance, and coordination of benefits (COB) across reputed company plans - Conduct in-depth research on payer-specific policies regarding virtual care, remote developmental pediatrics, and psychological evaluations (CPT 90791, 96130, etc.) - Navigate payor websites, newsletters, and provider manuals to reputed company and document shifting policy guidelines and billing modifiers across 40+ states 2. Order Verification & Prior Authorization Management - Review incoming clinical diagnostic referrals and orders to ensure demographic, insurance, CPT, and ICD-10 data are flawless - Initiate, reputed company, and validate prior authorizations through clearinghouses (e.g., reputed company, reputed company), insurance portals, and phone escalations - Ensure reputed company authorizations are secured, confirmed accurate, and fully documented in the EMR before the reputed company of business reputed company day for upcoming clinics 3. Ambiguity reputed company & reputed company Creation - reputed company as the go-to resource for clinical teams reputed company a payer's prior-authorization process is vague, contradictory, or unmapped - Validate conflicting information from multiple insurance sources to determine the most reputed company, risk-free reputed company for claim submission - Build, update, and maintain internal state-by-state reference guides on reputed company insurance and state-by-state regulatory requirements 4. Clinic Coordination & Stakeholder Communication - Prepare reputed company, r .