We're Hiring: Patient Eligibility-Authorization Specialist (Care Readiness)

Join our fast-growing behavioral health company and play a key role to help prospective and existing clients with Insurance Authorizations!

Location: Addison, TX (Near Beltline & Tollway)

Schedule: Full-Time | Monday-Friday | Required to work onsite In-Office

About Behavioral Innovations:

Celebrating 25 Years of Service: Behavioral Innovations (BI) is a leading provider committed to transforming lives by providing compassionate, center-based Applied Behavioral Analysis (ABA) therapy for children with autism, ages 18 months to 10 years. With more than 100+ locations across TX, OK, CO, VA, MD - and more to come - we’re continuing to expand rapidly. Join our dynamic team and make a meaningful difference in the lives of the families we serve.

Your Work and How You’ll Make a Difference:

As a key member of the BI team, the Patient Eligibility and Authorization Specialist is responsible for verifying patient insurance eligibility and benefits and obtaining pre-authorizations for outpatient services, specifically for ABA, in accordance with insurance carrier requirements. This role is critical in ensuring proper and timely documentation, tracking, and communication of client authorizations. The specialist works closely with clinical teams, area and regional leadership, insurance providers, the intake team, and billing personnel. Strong communication skills are essential for successful collaboration and resolution of insurance related issues. A thorough understanding of insurance payor guidelines, eligibility requirements, and authorization processes is required. The role requires proactive communication via phone and email with commercial, Medicaid, and managed care payors, and escalations to leadership when necessary. Communication must be solutionoriented and based on carrier guidelines, internal policies and procedures, detailed research, and thirdparty collection efforts.

Responsibilities:

• Maintain working knowledge of major commercial and government insurance payors and their guidelines.
• Verify insurance eligibility and benefits for all services provided by Behavioral Innovations (BI).
• Mentor Authorization Specialists by sharing best practices and training on authorization workflows.
• Manage submissions and follow-up for assessments, initial service authorizations, and re-authorizations.
• Ensure accurate documentation of authorization activities in both CRM and EHR systems.
• Communicate with payors to resolve pending or denied authorizations and provide timely updates to internal stakeholders.
• Track and monitor authorization thresholds to prevent lapses in coverage and service interruptions.
• Collaborate with clinicians to coordinate re-authorizations ahead of expiration dates.
• Work with the intake team to resolve paperwork issues that could delay assessments or initial authorizations.
• Identify and escalate trends in authorization denials, contributing to staff training and process improvements.
• Assist clinical teams in ensuring that documentation aligns with payor requirements for clean submissions.
• Navigate and utilize Electronic Medical Records (EMR) and billing systems effectively.
• Maintain positive relationships with internal teams and external payors to support efficient authorization processes.
• Perform other related duties as assigned.

Outcomes:

• Ensure Timely and Accurate Insurance Verification and Authorization- Verify insurance eligibility, manage all authorizations, and maintain accurate documentation to ensure uninterrupted services for clients.
• Complete insurance eligibility verification for 95% of new clients within 24 hours.
• Maintain a 98% accuracy rate in documenting authorizations in Salesforce and Central Reach systems.
• Ensure 100% of authorizations (initial and re-authorizations) are submitted before expiration to prevent service interruptions.
• Resolve Authorization Issues and Improve Payor Communication- Effectively manage communication with payors and internal teams to resolve pending or denied authorizations.
• Resolve 90% of pending or denied authorization within 4 business days.
• Provide status updates within 1 business day of payor communication.
• Identify and escalate recurring trends to the supervisor or team leads.
• Ensure Payor-Compliant Documentation for Successful Authorizations- Collaborate with clinical and intake teams to ensure all submitted documentation meets payor requirements and supports timely, clean authorizations.
• Ensure 100% of submissions include all required documentation prior to authorization request.
• Resolve documentation related issues within 48 hours in coordination with intake and clinical teams.

What We Are Looking For:

• Bachelor’s degree preferred.
• 3–5 years of experience in clinical operations, insurance verification, or authorization within a behavioral health or medical setting preferred.
• Excellent written and verbal communication skills with a strong focus on collaboration and customer service.
• Ability to manage multiple priorities in a fast-paced environment with strong attention to detail.
• Proficiency in Electronic Medical Records (EMR), CRM systems, and insurance portals.
• Proven problem-solving skills and initiative.
• Ability to maintain confidentiality and adhere to HIPAA standards.
• Must uphold BI’s core values and mission in all professional interactions.

Why Choose Behavioral Innovations:

• Compensation: Competitive Hourly rate

• Work-Life Balance: 10 days PTO, 7 paid holidays

• Insurance: Medical, Vision, Dental, and Supplemental Plans

• Wellbeing: Tools and programs to support physical, mental, and emotional wellness

• Employee Assistance Program (EAP): Comprehensive support

• Family-Centric Culture: Caring, collaborative environment

• Award-Winning Culture: Recognized for clinical excellence and ethical standards

• Mission-Driven Work: Help children with autism reach their full potential

• Values-Driven Organization: Integrity, accountability, collaboration, and family-focused care

Ready to Make a Difference?

Join Behavioral Innovations as a Patient Eligibility-Authorizations Specialist and contribute to a mission-driven team dedicated to helping children with autism thrive.

Apply today and be part of a growing, purpose-driven organization where your work directly impacts families and communities.

CORP2025