Reporting to the Billing Manager, the Insurance Authorization Specialist is responsible for obtaining authorization from insurance for required services. This role will also work with Third-Parties to help develop automated processes for authorizations where possible. Provide feedback to leadership team to ensure policies and processes are optimized and with a focus on patient service.

Geode Health is a rapidly growing, national provider of outpatient mental health services. Our mission is: To empower our patients to live healthier, more rewarding lives through accessible, affordable and effective mental healthcare to exceptional care tailored to their needs.

Job Responsibilities:

• Work with insurance companies, payers and other third-parties to ensure timely and accurate authorizations are obtained for services including: TMS, Spravato and others
• Work with contact center and front office personnel to ensure authorization information is properly added to the PM system and coordinate appointment scheduling
• Contact payers and/or patients to obtain required information to resolve claim issues and denials related to authorizations
• Provide expertise and oversight for automation where applicable
• Manage work effectively and timely
• Other duties as assigned

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
• Effective, professional, and courteous communication with patients and peers

Skills/Qualifications:

• 5+ years of experience working with Revenue Cycle software with in-depth knowledge of CPT and ICD-10 codes, insurance authorization requirements, and general insurance claim work
• Extensive knowledge and understanding of different types of insurance plans (HMO, PPO, POS, Medicare & Medicare Replacements, Medicaid and Medicaid Replacements)
• Extensive knowledge of insurance eligibility and benefits (copay, coinsurance, deductible)
• Some knowledge of provider contracts with insurance companies and how they affect claims
• Extensive knowledge and understanding of payer portals and when/how to utilize them
• Knowledge of Revenue Cycle processes, payer requirements for billing, and HIPAA
• Ability to learn contract requirements and apply to claim resolution efforts
• High School diploma or GED required; Associates Degree preferred

At Geode Health, we offer:

• Competitive compensation
• 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