Forge Health · 18 hours ago
Verification and Authorization Specialist
East Coast, USA
Full-time
Onsite
Mid Level
3+ years expForge Health is a mission-driven outpatient mental health and substance use provider dedicated to providing high-quality care. They are seeking a detail-oriented Verification and Authorization Specialist to verify insurance coverage, manage prior authorizations, and ensure effective communication with clients and staff.
ConsultingHealth CareMental HealthRehabilitation
Responsibilities
Verify clients’ insurance coverage and benefits to confirm service eligibility and determine out-of-pocket costs
Spend extensive time on the phone with insurance companies to confirm benefits, service limits, and authorization requirements
Access and navigate multiple payer portals (e.g., Availity, Optum, Aetna, Cigna) to verify benefits, submit authorizations, upload supporting documentation, and track approval statuses
Document detailed benefit information, including co-pays, deductibles, visit limits, covered services, and restrictions
Obtain and manage prior authorizations for services as required by payers, ensuring all relevant CPT codes, units, and service lines are accurately submitted
Track and monitor authorizations for approved visits, expiration dates, and required renewals to prevent disruptions in client care
Follow up with insurance carriers regularly to confirm receipt and approval of pending authorizations
Collaborate with clinical staff and management to gather clinical documentation or treatment information necessary for authorization requests
Maintain precise, timely documentation of all interactions with insurance carriers in the electronic health record (EHR)
Ensure strict confidentiality of client information in compliance with HIPAA and organizational policies
Provide professional and timely communication to clients and staff to support excellent customer service
Qualification
Required
3+ years of Insurance Verification and Authorization experience, preferably within a behavioral/mental health setting
Bachelor's degree required
Proficiency with electronic health record (EHR) and billing software
Extremely detail-oriented with excellent analytical, problem-solving, and organizational skills
Ability to keep confidential medical records of patients
Works well in groups as well as individually, with minimal supervision
Benefits
Comprehensive paid time off package
Annual time off to volunteer
Parental leave
Annual continuing education allocations
Competitive medical, dental, and vision package
Annual subscription to a leading meditation app
An environment that fosters professional development including financing for advanced licensure and certifications
Internal supervision opportunities
Company
Forge Health
Forge Health is a technology provider for substance use, mental health, or trauma patients.
201-500 employees
Funding
Current Stage
Growth StageTotal Funding
$11MKey Investors
MFO VenturesHC9 VenturesMontage Ventures
2024-08-22Series Unknown
2022-04-07Series Unknown· $11M
2017-01-01Seed
Leadership Team
Rondi Rabuse
Chief Executive Officer
Guy Maytal
Chief Medical Officer
Recent News
Behavioral Health Business
2025-07-04
Behavioral Health Business
2025-06-10
Behavioral Health Business
2025-06-01
Company data provided by crunchbase