Prior Authorization Specialist

Geode Health is a rapidly growing, national provider of outpatient mental health services. Our Mission is to “Transform mental health by making it more accessible, affordable and effective”.

Title: Prior Authorization Specialist

Cost Center: Operations

Location: Remote

We are looking for passionate Prior Authorization Specialist. The ideal candidate will be motivated by joining a quickly growing organization. Excited to help us improve the care experience for patients and providers. The Prior Authorization Specialist is a multi-skilled worker to ensuring and obtaining necessary prior authorizations from insurance companies. This role acts as a key team player when interacting and communicating with patients and/or clinical staff in the ambulatory care environment. Most importantly we’re looking to bring someone into our team who is excited about our mission to improve mental healthcare across the country.

Job Responsibilities:

• Initiates prior authorization requests with insurance companies by submitting necessary documentation and medical records
• Follow up on prior authorization requests, providing additional information as required and ensuring timely approvals for medications
• Establish clear communication channels on appointment details, prior authorization status, and insurance coverage information to patients, support staff, and providers
• Maintain accurate records of prior authorization requests, and insurance communications
• Serve as a liaison between providers, patients, and insurance companies to facilitate smooth communication and resolve any issues that may arise
• Secures patient information and maintains patient confidence by completing and safeguarding medical records
• Serves and protects the practice by adhering to professional standards
• Respond to verbal and electronic requests for information and assistance using proper policies, reference tools and provider instructions
• Maintains safe, secure and healthy work environment by establishing and following standards and procedures and complying with legal regulations
• Knowledge of emergency procedures and assist in crisis situations
• Understanding of policies and procedures
• Maintain client HIPAA rights, and other protections of confidentiality and privacy
• Ensure prompt, accurate, and efficient handling of documents for filing and scanning
• Copy/scan/fax/email information as required
• Complete all other relevant responsibilities as assigned by the supervisor
  
  

Ideal Candidate Profile:

• Passionate about our mission and inspiring others
• Self-starter, for whom no task is too big or too small and takes ownership of their decisions
• Contribute to the collective effort both within own scope - and beyond - as needed
• Creative and strategic thinker
• A lifelong learner who believes in giving and receiving feedback to get better each day
• Organized & process-oriented
  
  

Qualifications/Skills:

• At least one year of experience working in a medical office and/or mental health is (preferred)
• Experience working with prior authorization on medications (preferred)
• Ability to maintain professional appearance and demeanor, and interface well with patients in a mental health setting (preferred)
• Excellent communication skills and ability to work well with a team
• Proficiency in using electronic health records (EHR)
• Knowledge of medical terminology, insurance terminology, and billing practices
  
  

Education and Experience Requirements:

• High school diploma or equivalent required; Associate’s or bachelor’s degree preferred
• Some experience in healthcare settings or insurance verification is highly desirable
• Knowledge of working at a clinical setting (preferred)
  
  

At Geode Health, we offer:

• Competitive compensation
• Flexible schedule
• In-person and virtual patient visits
• Comprehensive admin support (front office, accounting, finance, payroll, HR, etc)
• Professional development opportunities
• Clinical community, support, and leadership
• Medical, dental and vision benefits
• Life insurance
• Short and long-term disability
• Paid vacation and holidays
• Matching 401k plan
• State of the art technology
  
  

Why work for Geode Health?

At Geode Health, we take our commitment to patients and providers seriously. We focus every day on how to help patients across the United States get the best possible mental health care available. To achieve this, we focus on ensuring our providers have unmatched support and resources so that they can focus on providing great care. We are backed by KKR, a leading private equity firm with the experience and mission alignment to truly make an impact. Joining Geode Health will put you on the front-end of a rapidly growing movement to increase access and improve outcomes for mental health patients and providers across the nation.

To learn more, visit us as www.geodehealth.com

Geode Health is an Equal Opportunity Employer. We respect and seek to empower each individual and support the diverse cultures, perspectives, skills and experiences of our workforce.