Job Title MENTAL HEALTH Precertification Specialist for TMS and Spravato Overview As a TMS and Spravato Precertification Specialist your primary responsibility will be to ensure the smooth and efficient process of obtaining preauthorization and precertification for transcranial magnetic stimulation procedures and Spravato TMS is a non-invasive neurostimulation technique used to treat various neurological and psychiatric conditions In this role you will collaborate with medical staff insurance companies and patients to navigate the precertification process and ensure timely approval for TMS and Spravato treatments Spravato esketamine is a prescription nasal spray used to treat treatment-resistant depression in adults It works differently from traditional antidepressants by targeting glutamate receptors in the brain Spravato is taken under medical supervision usually in a clinic due to its potential side effects and risk of misuse Duties Insurance Coordination Work closely with healthcare providers and insurance companies to gather and submit the necessary documentation for TMS procedure preauthorization Doctor Communication Communicate with doctors or doctor s office to explain the precertification process provide information about insurance coverage and assist in gathering required medical records Documentation Maintain accurate and up-to-date records of patient information medical documentation and insurance correspondence related to precertification Review and Verification Review patient medical histories diagnoses and treatment plans to ensure alignment with insurance requirements for precertification Submission of Requests Prepare and submit preauthorization requests to insurance companies following established protocols and guidelines Follow-up Track the progress of preauthorization requests and follow up with insurance companies to expedite the approval process Problem Resolution Address any issues denials or discrepancies that may arise during the precertification process and work collaboratively with medical staff insurance representatives and doctors to resolve them Compliance Ensure adherence to all relevant regulations guidelines and policies related to TMS procedures patient information and insurance procedures Data Management Maintain a well-organized database of patient information insurance contacts and precertification outcomes Reporting Generate regular reports summarizing the status of precertification requests approvals and denials for review by relevant stakeholders Familiarity with medical terminology insurance procedures and healthcare regulations Strong communication skills both written and verbal Excellent organizational and time-management abilities Attention to detail and accuracy in record-keeping Qualifications Must be a self-starter able to work responsibly and independently Previous experience in medical office administration and insurance precertification Insurance verification and Healthcare customer service Familiarity with medical terminology insurance procedures and healthcare regulations Strong communication skills both written and verbal Excellent organizational and time-management abilities Attention to detail and accuracy in record-keeping Must be a fast learner Excellent in speaking and understanding English Must have in-depth understanding of the US Healthcare System Joining our team as a Specialist offers the prospect to work in a dynamic environment where your skills and expertise will be valued If you are looking to make a meaningful impact in the MENTAL HEALTH industry we encourage you to apply Job Type Full-time Pay From 87 000 00 per month Benefits Work from home Schedule Monday to Friday Supplemental Pay Overtime pay Yearly bonus