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

Josi Health is a fast-growing, virtual-first healthcare company dedicated to making neurodivergent care faster, more accessible, and stress-free for families. We are seeking a detail-oriented Eligibility, Benefits, and Prior Authorization Specialist to join our team and ensure seamless patient access to care.

Key responsibilities

• Verify patient insurance coverage, including deductibles, co-pays, and coordination of benefits across various commercial plans.
• Conduct in-depth research on payer-specific policies regarding virtual care and psychological evaluations to ensure accurate billing.
• Initiate, track, and validate prior authorizations through insurance portals and clearinghouses to prevent administrative delays.
• Build and maintain internal state-by-state reference guides to clarify complex or ambiguous insurance requirements.
• Collaborate with clinical staff to resolve scheduling exceptions and communicate benefit information clearly to stakeholders.

Requirements

• At least 2 years of experience in healthcare administration, specifically focusing on insurance verification and prior authorizations.
• Strong research skills with the ability to navigate payer portals and interpret complex policy manuals.
• Solid understanding of medical terminology, CPT codes, ICD-10, and telehealth billing modifiers.
• Excellent written and verbal English communication skills for professional interaction with payers and internal teams.
• Ability to work full-time during EST business hours with a reliable high-speed internet connection.

What we offer

• Fully remote work environment for candidates based outside of the United States.
• Competitive monthly compensation paid in USD.
• Opportunity to contribute to a mission-driven company with significant potential for professional growth.
• Access to modern operational tools and technology to support your daily workflows.