Stella Mental Health

General

• Complete comprehensive Verification of Benefits, ensuring patients and internal teams have clear, accurate financial and coverage information.
• Initiate and manage Prior Authorizations for interventional services, ensuring timely submission and thorough follow-through.
• Proactively track authorization status and communicate updates to internal stakeholders.
• Challenge denials by initiating appeals, coordinating peer-to-peer reviews, and identifying alternative pathways to access care.
• Ensure patients experience minimal delays in starting treatment through persistent, proactive follow-up.
• Own end-to-end VOB and PA workflows, from intake to resolution, within defined turnaround times.
• Utilize internal systems including EMR (Athena/DrChrono), Salesforce, payer portals, and AI tools to complete and track work efficiently.
• Maintain accurate, up-to-date documentation across all systems to support visibility and reporting.
• Collaborate closely with Patient Care Coordinators, Treatment Coordinators, and clinic teams to ensure seamless patient access.
• Partner with Payor Relations and Clinical teams to escalate denials and resolve complex cases.
• Identify trends in denials, payer behavior, and workflow inefficiencies and escalate opportunities for improvement.
• Contribute to the development and refinement of standardized workflows, playbooks, and best practices.

Access Specialist