Help streamline behavioral health authorizations and support patient access to care with your expertise in Spravato and TMS services.
About Assembly Health
Assembly Health is a healthcare management services organization (MSO) headquartered in Chicago, IL. We provide clinical services and business solutions to long-term care facilities and physician practices across the country, serving more than 4,000 facilities and 300 practices in over 40 states. Our mission is to help communities and providers perform at their best so patient care continually improves.
Schedule
- Full-time, remote position
- Standard business hours with flexibility as needed
- Reports to the Utilization Review team leadership
What You’ll Do
- Obtain and manage prior authorizations for Spravato and TMS services across commercial and government insurance plans
- Ensure timely submission of clinical documentation, including medical necessity letters, progress notes, rating scales, and treatment plans
- Review payer medical policies and apply medical necessity criteria for coverage decisions
- Coordinate with providers, clinical staff, and billing teams to ensure accurate submissions
- Track authorization requests, denials, appeals, and renewals; maintain detailed records of payer communication
- Support new customers by guiding them through authorization processes and documentation requirements
- Stay updated on insurance requirements, payer policies, and clinical standards
- Take on additional projects and tasks as assigned
What You Need
- Minimum 2 years of experience in prior authorization, utilization review, or billing (behavioral health or neuromodulation preferred)
- Strong knowledge of Spravato and TMS medical necessity criteria, including CMS, commercial payer, and MassHealth guidelines
- Experience with Massachusetts and Rhode Island-specific carriers
- Familiarity with EHR systems, payer portals, and medical documentation
- Highly organized, detail-oriented, and skilled at managing multiple priorities
- Strong written and verbal communication skills
- Preferred: experience with in-network and out-of-network workflows or REMS-certified treatment programs
Benefits
- Salary range based on skills, experience, and qualifications
- Comprehensive benefits package including medical, dental, and vision insurance
- 401(k) with employer match
- Paid holidays and paid time off
- Opportunity to contribute to a growing, acquisition-focused healthcare organization
- Career growth supported by ongoing training and development
Join Assembly Health and make an impact by ensuring timely and accurate authorization processes that help patients get the care they need.
Happy Hunting,
~Two Chicks…