Benefits, Eligibility, & Prior Auths Specialist at Finni Health

, , Philippines -

Full Time

Start Date

Immediate

Expiry Date

19 Dec, 25

Salary

0.0

Posted On

20 Sep, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Benefits Verification, Eligibility Checks, Prior Authorizations, Healthcare Operations, Problem-Solving, Collaboration, Administrative Acumen, Communication, Organizational Skills, Time Management, Tech Proficiency, Adaptability, Attention to Detail, Payer Communication, Documentation, Process Improvement

Industry

Hospitals and Health Care

Description

About Finni Health Finni Health empowers autism care providers to start, run, and grow their own practices. We democratize autism care by providing access to our insurance network, purpose-built EHR software, HR solutions, and clinical support. We've experienced rapid growth and are backed by top-tier investors like General Catalyst and YCombinator. We seek bright, driven individuals eager to innovate in a dynamic, fast-paced environment. What You Will Be Doing Benefits & Eligibility Oversight: Ensure the accuracy and timeliness of benefit and eligibility checks performed by our 3rd-party vendor. Step in directly to resolve escalations or complex cases that require additional investigation, payer communication, or specialized follow-up. Prior Authorization Escalation Management: Handle edge cases related to prior authorization submissions, such as denials, urgent approvals, or unclear payer requirements. Ensure providers have what they need to start or continue services without interruption. Vendor Support & Partnership: Serve as the escalation point for the vendor, answering their questions, clarifying requirements, and stepping in when situations fall outside standard workflows. Build a collaborative relationship to improve efficiency and accuracy. Cross-Team Coordination: Work closely with Provider Success, Billing, and RCM teams to ensure escalated benefit or authorization issues are resolved quickly. Keep providers and internal stakeholders informed of resolution timelines and outcomes. Documentation & Compliance: Maintain accurate and detailed records of escalations, payer communications, and final resolutions. Ensure all documentation complies with payer policies, HIPAA, and Finni Health standards. Continuous Process Improvement: Identify recurring edge cases or vendor pain points, and work with leadership to improve processes, training, or documentation that can reduce future escalations. Adaptable Responsibilities: As Finni Health grows and evolves, your role may expand to include new responsibilities that support our mission and improve the provider and patient experience. About You You are a problem-solver who thrives on untangling complex situations and ensuring patients get uninterrupted access to care. Based in the Philippines, you bring strong attention to detail, excellent follow-through, and confidence in working directly with payers and vendors to resolve issues. Experience: 1–3 years of experience in benefits verification, eligibility checks, prior authorizations, or healthcare operations. Hands-on experience resolving payer escalations is highly valued. Problem-Solving: Strong ability to investigate, troubleshoot, and resolve complex benefit and authorization issues with persistence and accuracy. Collaborative & Independent Contribution: Capable of working independently on escalations while keeping internal teams informed and aligned. Administrative Acumen: Organized, detail-oriented, and confident in reviewing insurance documentation, payer guidelines, and vendor reports. Communication & Collaboration: Excellent communicator, able to explain complex payer requirements clearly to providers, families, vendors, and internal teams. Organizational & Time Management: Skilled at managing multiple escalations and prioritizing urgent cases without losing track of long-term follow-ups. Tech Proficiency: Proficient in Google Suite, Slack, CRMs/support systems, and comfortable learning new EHR and RCM tools. Mission Alignment: Passionate about Finni’s mission to democratize autism care by ensuring families experience smooth, uninterrupted access to services. Adaptability & Agility: Thrives in a fast-paced startup, embraces change, and approaches ambiguity with a proactive, solution-focused mindset.

Responsibilities

The specialist will oversee benefits and eligibility checks, manage prior authorization escalations, and coordinate with various teams to resolve issues. They will also maintain documentation and work on continuous process improvement.