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”.

We are looking for a passionate Prior Authorization Specialist. The ideal candidate will be motivated by joining a quickly growing organization and excited to help us improve the care experience for patients and providers. The Prior Authorization Specialist is a multi-skilled worker focused on 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 onto our team who is excited about our mission to improve mental healthcare across the country.

This is a part-time role working 20 hours per week, Monday - Friday from 9am - 1pm CST.

Job Responsibilities:

• Initiates prior authorization requests with insurance companies by submitting necessary documentation and medical records
• Follows up on prior authorization requests, providing additional information as required and ensuring timely approvals for medications
• Establishes clear communication channels on prior authorization status and insurance coverage information to patients, support staff, and providers
• Maintains accurate records of prior authorization requests and insurance communications
• Serves 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
• Responds to verbal and electronic requests for information and assistance using proper policies, reference tools, and provider instructions
• Maintains a safe, secure, and healthy work environment by establishing and following standards and procedures and complying with legal regulations
• Demonstrates knowledge of emergency procedures and assists in crisis situations
• Understands clinic policies and procedures
• Maintains client HIPAA rights and other protections of confidentiality and privacy
• Ensures prompt, accurate, and efficient handling of documents for filing and scanning
• Copies/scans/faxes/emails information as required
• Completes 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
• Contributes 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 improve each day
• Organized and process-oriented

Qualifications/Skills:

• At least one year of experience working in a medical office and/or mental health (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
• 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 in a clinical setting (preferred)

#LI-Remote

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.

Estimated hourly pay range:

$24.00-$27.00