Benefits Verification Specialist

Job Summary

A company is looking for a Benefits Verification/Prior Authorization Specialist.

Key Responsibilities

• Execute comprehensive benefit verification and perform complex coverage analysis for Spravato and TMS
• Manage the full prior authorization lifecycle, ensuring timely submissions and follow-ups
• Communicate effectively with providers, providing clear and concise updates on benefit summaries and prior authorizations

Qualifications & Requirements

• 2+ years of experience in Benefit Verification and Prior Authorization
• Understanding of medical and pharmacy benefits, including PBM concepts
• Experience with CoverMyMeds and major payer portals
• Ability to write clear and professional messages for provider communication
• Comfortable using AI tools in daily workflow