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RCM Benefits Verification / Prior Authorization Specialist

OsmindPsychiatry EHR company
United StatesMid
DFJ Growth logo
DFJ Growth
Future Ventures
General Catalyst logo
General Catalyst
Y Combinator logo
Y Combinator
Tiger Global logo
Tiger Global
Pear VC logo
Pear VC
Operations & Strategy

About the role

TL;DR

Verifies patient benefits and manages prior authorizations for interventional psychiatric treatments.

  • The Benefits Verification & Prior Authorization (BV & PA) Specialist is a vital role in Osmind's RCM operation, ensuring accurate and timely verification and authorization for interventional psychiatric treatments.
  • Key Responsibilities Conduct comprehensive benefit verifications via phone and portal.
  • Manage the full prior authorization lifecycle for Spravato, TMS, and other treatments.
  • Investigate and resolve payer pushback and discrepancies.
  • Communicate clearly and professionally with practices regarding VOB and PA status.
  • Manage personal queue and learn new proprietary tools independently.
  • Requirements 2+ years of hands-on experience in benefit verification and prior authorization.
  • Strong understanding of VOB vocabulary and mechanics.
  • End-to-end PA lifecycle experience, including denial management and appeals.
  • Experience with major payer portals and pharmacy PA platforms.
  • Clear, professional written English communication skills.
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Domain expertise

healthcare

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