Behavioral Practice-Prior Authorization Specialist

Company Description Staffingly, Inc. is a healthcare outsourcing partner focused on helping medical organizations address staff shortages and reduce revenue loss. The company provides 24/7, secure, and HIPAA-compliant services delivered by professionals with advanced degrees and specialized certifications. Service offerings include insurance verification, prior authorization, medical reception, telemedicine support, medical data entry, coding, scribing, and revenue cycle management. Staffingly emphasizes cost efficiency, strong healthcare software proficiency, and specialized patient customer care to improve operational performance and patient experiences. Clients can explore the company’s solutions through a 15-day free trial.
Role Description The Behavioral Practice–Prior Authorization Specialist is a full-time, remote role responsible for managing prior authorizations for behavioral health services. This position reviews clinical documentation, verifies insurance coverage, and submits accurate and timely prior authorization requests to payers. The specialist follows up on submitted requests, resolves denials or appeals, and communicates authorization status to providers, front-desk teams, and billing staff. Daily responsibilities include coordinating with behavioral health clinicians, interpreting payer policies, maintaining detailed records in practice management or EHR systems, and ensuring compliance with HIPAA and organizational standards. The role also involves identifying process improvements, supporting revenue cycle efficiency, and contributing to positive patient and provider experiences through clear, professional communication.
Qualifications

• Strong foundation in behavior-focused disciplines, including Behavior Analysis and Applied Behavior Analysis, to understand behavioral health treatment plans and documentation.
• Experience with Behavior Management and Behavior Modification concepts to interpret clinical notes and align authorizations with treatment needs.
• Background in Psychology or related field to navigate behavioral health terminology and payer requirements.
• Knowledge of behavioral health insurance policies, prior authorization workflows, and revenue cycle processes.
• Proficiency using EHR/practice management systems and payer portals for authorization submissions and tracking.
• Excellent written and verbal communication skills for collaborating with clinicians, patients, and insurance representatives.
• Strong attention to detail, organizational skills, and ability to manage multiple authorization requests and deadlines simultaneously.
• Demonstrated ability to work independently in a remote environment, maintain confidentiality, and adhere to HIPAA and compliance standards.
• Prior experience in behavioral health administration, prior authorization, medical billing, or insurance verification is highly beneficial.
• Associate’s or Bachelor’s degree in psychology, healthcare administration, or a related discipline preferred, or equivalent relevant experience.