Osmind

RCM Benefits Verification / Prior Authorization Specialist

United States

Sponsorship not specified$60k-$65kDetected 375 days ago

Object-Oriented ProgrammingEHR/EMRResearchCommunication

About the role

The Benefit Verification & Prior Authorization (BV & PA) Specialist is one of the most vital roles in our RCM operation.
Accurate, timely BV and PA work is the foundation on which everything downstream is built - patient financial estimates, claim submission, denial avoidance, and cash flow.
When it's wrong, the consequences cascade.

Own the full PA lifecycle for Spravato, TMS, and other treatments: initial submission through approval, with proactive re-authorization so there are never gaps in care.
When a VOB or PA response doesn't add up, you investigate - you don't just document and move on.
Manage your own queue. Flag expiring authorizations before they expire. Raise blockers promptly and specifically - don't sit on problems.
Once a patient is confirmed as clinically appropriate, you own the VOB from start to finish.

Experience with major payer portals (Availity, Navinet, Optum, or payer-specific) and pharmacy PA platforms (CoverMyMeds or comparable)
Clear, professional written English - you can write a provider-facing message that needs zero edits
Demonstrated ability to learn new technology independently
This role will be based in the United States with minimal travel required.

Mental health disorders are one of the leading causes of death worldwide and are tied to shortened life expectancies.
Comprehensive Benefit Verification
Conduct thorough phone and portal-based benefit verifications.
Determine the details automated checks miss - medical vs. pharmacy routing, code-level coverage, exact deductible/OOP status, coinsurance, coordination of benefits, and prior authorization requirements.
Understand what each payer requires and confirm clinical documentation supports medical necessity before submission.
Identify whether the issue is a data error, a policy misapplication, or a legitimate coverage limitation.
Every benefit summary, PA update, and denial communication should be something a provider can act on without a follow-up call.
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 Benefit Verification & Prior Authorization (BV & PA) Specialist is one of the most vital roles in our RCM operation.

Osmind is a technology, services, and data company focused exclusively on psychiatry.
At Osmind, we serve a network of 1,000+ independent psychiatry practices across the country.
We help these clinics provide high-quality care, scale as businesses, and contribute to research through our purpose-built EHR, software solutions, and managed services.
Yet, we have cause for hope: there have been landmark developments in psychiatric medications and treatments - including ketamine, Spravato, and neuromodulation - and a growing movement among clinicians, patients, and researchers to close the gap between scientific innovation and real-world care.
Our providers are at the forefront of psychiatry, treating some of the highest-acuity patients in the country.
About Us Osmind is a technology, services, and data company focused exclusively on psychiatry.

This listing is sourced directly from Osmind's careers page and normalized into a canonical job model.