Job Description
About Us
Osmind is a technology, services, and data company focused exclusively on psychiatry. Mental health disorders are one of the leading causes of death worldwide and are tied to shortening lifespans. Yet, we have cause for hope: there have been developments in new psychiatric medications since the first FDA approval in 1954, such as new treatments like ketamine, Spravato, and neuromodulation. Now, there is a growing movement among clinicians, patients, and researchers to close the gap between this scientific innovation and better real-world care.
At Osmnid, we serve a network of 800+ independent psychiatry practices across 49 states. We help these clinics effectively provide high-quality care, scale as businesses, and contribute to research with our purpose-built EHR, software solutions, clinician community, and managed services. Our providers are at the forefront of psychiatry, offering innovative interventions and treating some of the highest acuity patients in the country.
Osmind is a San Francisco–based public benefit corporation backed by top investors including DFJ Growth, Future Ventures, General Catalyst, and Y Combinator.
Role Overview
The primary role of Prior Authorization Specialist is to serve as the subject matter expert navigating the complexities of prior authorization and insurance verification. Individuals who succeed in this role will demonstrate the ability to decipher insurance jargon with ease, understand healthcare regulations, and have the ability to properly research issues with insurance carriers.
Key ResponsibilitiesMaintain current knowledge of insurance policies, regulations, and requirements to ensure compliance with industry standardsAbility to meet productivity and quality measurement requirementsWork collaboratively with internal and extended business office staffReview patient medical records and insurance information to determine which services require authorizationCoordinate with the practices and insurance companies to obtain pre-authorization for medical procedures, treatments, and medicationsCommunicate with patients and healthcare providers regarding the status of authorization requests and any changes in coverageParticipate in the development of coding and billing strategies, evaluating processes related to Revenue Cycle and making recommendations while ensuring compliance with any relevant rules or regulations (including HIPAA, Medicaid, Medicare, and specific third-party payers)Maintains professional relationships and collaborates across teamsPrepares and coordinates revenue cycle responsibilities within the acquisition/implementation process. This includes but is not limited to staff onboarding, vendor management, and clearinghouse management.Required Qualifications3+ years of experience in prior authorization and insurance verificationDeep understanding of CPT coding, insurance claim processing, and payer reimbursement modelsDemonstrated expertise with services like TMS, Spravato, and other interventional psychiatric treatmentsExcellent research and comprehension skills for behavioral healthcare regulationsAdaptability and comfort with new technologiesAbility to work independently, collaboratively, and reliablySelf-starter mentality with a problem-solving approachThrives in a dynamic environment and welcomes new challengesLocation
This role will be based in the United States with minimal travel required.
This is a unique opportunity to help build a transformative healthcare organization from the ground up while solving critical challenges for psychiatric providers and their patients. The successful candidate will play a key role in shaping the future of mental healthcare delivery.
