- Obtain and manage prior authorizations for Spravato and TMS services from commercial and government insurance plans
- Ensure timely submission of required clinical documentation, including medical necessity letters, progress notes, rating scales, and treatment plans
- Review payer-specific medical policies to determine criteria for Spravato and TMS coverage
- Coordinate with providers, clinical staff, and billing teams to ensure complete and accurate information is submitted
- Frequently track and follow up on authorization requests, denials, appeals, and renewals
- Maintain detailed records of payer communication, submission timelines, and authorizations received
- Provide support to new customers who are in their start-up phase by navigating authorization processes and clinical documentation
- Stay current on changes in insurance requirements, payer policies, and clinical documentation standards
EHR