Role Overview:
- Vital role in RCM operation, impacting patient financial estimates and cash flow.
- Handles Prior Authorizations from start to finish, ensuring the practice is working with the best in the industry.
- Executes the full BV and PA lifecycle for interventional treatments, including phone- and portal-based verification.
Key Responsibilities:
- Executes comprehensive checks and complex coverage analysis.
- Manages the full PA lifecycle for Spravato and TMS, from initial submission through approval.
- Reviews portal benefit details, transposes data into the EHR, and verifies enrollment forms.
Qualifications & Requirements:
- Requires 2+ years of experience in Benefit Verification and Prior Authorization.
- Must be fluent in coverage, including medical and pharmacy benefits, and PBMs.
- Comfortable with open, frequent, direct communication and raising blockers fast.
Strong Pluses:
- Significant differentiator: Spravato and/or TMS BV/PA experience.
- Experience with Spravato withMe portal and Pylon.
- Familiarity with mental health/psychiatry benefits.
Osmind
Osmind is a technology, services, and data company focused exclusively on psychiatry. They serve a network of 1,000+ independent psychiatry practices across the country, helping them provide high-quality care, scale as businesses, and contribute to research with their purpose-built EHR, software solutions, clinician community, and managed services.