Verifies insurance eligibility and benefits, obtains and tracks prior and retrospective authorizations, documents payer requirements, calculates patient responsibility, identifies denial risks, and supports appeals. The specialist coordinates with providers, clinical staff, schedulers, billing teams, patients, and insurance payers while maintaining accurate records, monitoring authorization deadlines, resolving coverage issues, and complying with HIPAA and privacy standards in a remote setting.
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
- High school diploma or equivalent
- Minimum of four (4) years of experience in insurance verification, prior authorization, retrospective authorizations or medical billing in a physician practice or outpatient setting
- Working knowledge of commercial insurance, Medicare, and Medicaid plans, including HMO/PPO structures and authorization processes
- Familiarity with CPT, ICD-10, and HCPCS coding as it relates to eligibility and authorization
- Experience using payer portals (e.g., Availity) and practice management / EHR systems
- Strong attention to detail, organization, and follow-through
- Excellent written and verbal communication skills
- Ability to work independently in a remote environment with reliable high-speed internet and a private, HIPAA-compliant workspace
Preferred Qualifications
- Bilingual (English/Spanish)
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.
Similar Jobs
Aerospace • Artificial Intelligence • Machine Learning • Robotics • Software
Manage the global travel and expense program, including Concur administration, expense report processing, corporate-card reconciliation, audits, policy compliance, employee support, reporting, and process improvements. Partner with Accounting, Accounts Payable, FP&A, HR, and IT to maintain accurate financial data, effective controls, system integrations, and timely reimbursements.
Top Skills:
Concur ExpenseConcur TravelCorporate Card PlatformsErpHrisExcelMS OfficeNetSuiteOracleSAP
Aerospace • Hardware • Information Technology • Security • Software • Cybersecurity • Defense
Manage multiple concurrent IT infrastructure, application, cybersecurity, and compliance projects across cloud and on-premises environments. Lead projects through planning, execution, delivery, stabilization, and benefit realization while managing scope, schedules, budgets, risks, resources, vendors, stakeholders, and organizational change. Develop business cases and execution strategies, coordinate dependencies, guide teams, and communicate with executives. Ensure customer satisfaction, project success, and alignment with organizational objectives.
Top Skills:
AgileExcelMicrosoft PowerpointMicrosoft ProjectMicrosoft WordServicenow Spm
Aerospace • Hardware • Information Technology • Security • Software • Cybersecurity • Defense
Leads end-to-end execution of multiple concurrent IT projects across infrastructure, applications, cybersecurity, compliance, cloud, and on-premises environments. Manages planning, execution, delivery, stabilization, benefits realization, requirements, schedules, budgets, risks, resources, vendors, stakeholders, organizational change, and executive communications. Requires strong agile project leadership, customer focus, financial management, and cross-functional coordination.
Top Skills:
AgileCloudExcelMicrosoft PowerpointMicrosoft ProjectMicrosoft WordServicenow Spm
What you need to know about the Los Angeles Tech Scene
Los Angeles is a global leader in entertainment, so it’s no surprise that many of the biggest players in streaming, digital media and game development call the city home. But the city boasts plenty of non-entertainment innovation as well, with tech companies spanning verticals like AI, fintech, e-commerce and biotech. With major universities like Caltech, UCLA, USC and the nearby UC Irvine, the city has a steady supply of top-flight tech and engineering talent — not counting the graduates flocking to Los Angeles from across the world to enjoy its beaches, culture and year-round temperate climate.
Key Facts About Los Angeles Tech
- Number of Tech Workers: 375,800; 5.5% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Snap, Netflix, SpaceX, Disney, Google
- Key Industries: Artificial intelligence, adtech, media, software, game development
- Funding Landscape: $11.6 billion in venture capital funding in 2024 (Pitchbook)
- Notable Investors: Strong Ventures, Fifth Wall, Upfront Ventures, Mucker Capital, Kittyhawk Ventures
- Research Centers and Universities: California Institute of Technology, UCLA, University of Southern California, UC Irvine, Pepperdine, California Institute for Immunology and Immunotherapy, Center for Quantum Science and Engineering
