RCM Prior Authorization / Benefits Verification Specialist
Osmind
Accounting & Finance
United States
Posted on Jul 12, 2025
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.
Position Overview
We are seeking a dual-skilled RCM specialist to serve as our subject matter expert in both prior authorization and benefits verification processes. This role is critical to our expanding revenue cycle management services for psychiatric clinics, requiring someone who can navigate insurance complexities. The ideal candidate will demonstrate expertise in deciphering insurance policies, understanding healthcare regulations, and ensuring smooth RCM front-end processes for downstream clean claims and collections.
What You'll Do
- Prior Authorization
- Review patient medical records and insurance information to determine authorization requirements
- Coordinate with practices and insurance companies to obtain pre-authorization for medical procedures, treatments, and medications
- Maintain current knowledge of insurance policies, regulations, and requirements to ensure compliance
- Communicate with patients and healthcare providers regarding documentation requirements, authorization status, and coverage changes
- Benefits Verification
- Gather necessary information to verify benefits insurance coverage, navigate behavioral health benefit complexities such as carveouts
- Leverage technology tools and payer phone calls to efficiently and accurately verify and investigate benefits for patients
- Maintain detailed records of insurance verification activities and statuses
- Strategic & Operational Support
- Provide expert guidance on mental health front-end processes, with a specific focus on complex treatments like TMS and Spravato
- Directly interface with clinic owners, practice managers, and billing partners, and provide support and best practice guidance
- Propose process enhancements, automation, or system improvements to streamline operations and enhance the overall effectiveness of benefits verification and prior authorization activities
- Collaborate effectively with back-end RCM team members to identify and address any issues
- Stay current on industry trends, regulatory changes, and payer policies impacting mental health billing
Required Experience
- 3+ years of experience in healthcare revenue cycle management with demonstrated expertise in both prior authorization and benefits verification
- Demonstrated expertise with Spravato benefits verification and prior authorization - this is absolutely essential
- Excellent research, communication, organization, and problem-solving skills
- Proficiency in EHR systems and practice management software
- Ability to work independently and collaboratively in a fast-paced environment
- Self-starter mentality with adaptability to new technologies
Nice to Haves
- Experience working in or consulting for an MSO or large psychiatric practice group
- Experience with TMS and other interventional psychiatric treatments
- Excitement to adopt technology and AI to automate benefits verification and prior authorization processes
- Experience with data analytics tools and generating actionable insights from RCM data
Location
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.
