Careforce is reimagining outpatient care. Backed by a multi-million-dollar seed round from W Health Ventures and incubated by 2070 Health, we're building a next-gen Holdco of asset-light MSOs, purpose-built for physician-led specialty practices. Our platform is designed to streamline operations, enhance clinical quality, and accelerate growth. We're starting with Interventional Psychiatry-bringing modern infrastructure, operational excellence, and scalable support.
About the Role
We are seeking a detail-oriented and experienced
RCM Specialist
with a strong background in
Prior Authorization (PAR) workflows
within the behavioral health domain, specifically
interventional psychiatry
services such as
Transcranial Magnetic Stimulation (TMS)
and
Spravato (Esketamine)
.
This is a
clinical-facing administrative role
that involves processing complex prior authorizations that require understanding clinical documentation, payer requirements, and the nuances of behavioral health treatment protocols.
Requirements
Prepare, submit, and track prior authorization requests for behavioral health treatments including TMS, Spravato, and other psychiatric interventions
Review medical records and clinical notes to extract relevant documentation required for insurance approval
Understand and apply payer-specific guidelines (including Medicare, Medicaid, and commercial carriers) for psychiatric services
Coordinate with onshore teams to obtain missing information and clarify clinical documentation
Follow up on submitted authorizations to ensure timely approvals or manage denials
Maintain accurate records in practice management or EMR systems and payer portals
Communicate professionally with internal stakeholders regarding the status and next steps for each case
Requirements
Qualifications
Minimum 6
years of hands-on experience
in
RCM/PAR
workflows within the
U.S. behavioral health
or
interventional psychiatry
space
Strong familiarity with
insurance guidelines
for TMS, Spravato, and similar interventions
Proven ability to work with
clinical documentation
, including reviewing physician notes and extracting key information for payers
Experience using EMR and prior auth submission platforms (e.g., Availity, CoverMyMeds, payer portals)
Excellent attention to detail and time management in a fast-paced setting
Strong written and verbal English communication skills
Preferred Experience
Exposure to U.S. Medicare LCDs or medical necessity criteria for psychiatric procedures
Experience working with U.S. based teams or clinicians
Familiarity with appeals and peer-review processes for denied authorizations
Benefits
You'll be working in a mission-driven environment that aims to improve access to innovative psychiatric care. This role offers long-term potential and the opportunity to be an integral part of a growing RCM team specialized in behavioral health.
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