Prior Authorization Specialist

Prior Authorization Specialist

Nashville, TN

Why Charlie Health?

Millions of people across the country are navigating mental health conditions, substance use disorders, and eating disorders, but too often, they're met with barriers to care. From limited local options and long wait times to treatment that lacks personalization, behavioral healthcare can leave people feeling unseen and unsupported.

Charlie Health exists to change that. Our mission is to connect the world to life-saving behavioral health treatment. We deliver personalized, virtual care rooted in connectionbetween clients and clinicians, care teams, loved ones, and the communities that support them. By focusing on people with complex needs, we're expanding access to meaningful care and driving better outcomes from the comfort of home.

As a rapidly growing organization, we're reaching more communities every day and building a team that's redefining what behavioral health treatment can look like. If you're ready to use your skills to drive lasting change and help more people access the care they deserve, we'd love to meet you.

About This Role

This role is responsible for driving the foundational stages of the reimbursement cycle by managing initial and mid-stay authorizations, payor notifications, and daily billing system triaging. Securing timely authorizations and maintaining precise documentation is a critical step in the financial process, directly preventing coverage gaps and administrative denials. By proactively managing these worklogs, this specialist ensures steady revenue flow, minimizes financial risk during a client's treatment stay, and protects the organization's ability to get reimbursed for services.

Our team is composed of passionate, forward-thinking professionals eager to take on the challenge of the mental health crisis and play a formative role in providing life-saving solutions. We are looking for a candidate who is inspired by our mission and excited by the opportunity to build a business that will impact millions of lives in a profound way.

Responsibilities

• Submitting initial authorization requests and tracking progress through final payor outcome to ensure coverage is active prior to service delivery.
• Managing and submitting new policy authorization requests for active clients who experience a change in coverage mid-treatment stay.
• Issuing timely notifications of non-admission to specific payors to remain compliant with strict contractual notice requirements.
• Triaging and prioritizing daily worklog tasks within the RCM billing system to resolve bottlenecks and keep claims moving forward.
• Executing ad hoc authorization and billing tasks as directed by management to support general department workflows and revenue capture.

Requirements

• 23 years of related work experience in healthcare administrative roles, specialized billing, prior authorizations, insurance verification, or claims management
• Strong knowledge of prior authorization processes, payor portals, and medical billing practices
• Proficiency with RCM billing systems and workflow triaging to effectively navigate and manage daily electronic task queues
• Knowledge of all confidentiality requirements (HIPAA) regarding patients and strict maintenance of proper confidentiality on all such information
• Excellent written and verbal communication skills for professional and persistent correspondence with insurance payors
• Strict attention to detail to ensure complex authorization timelines, dates of service, and policy numbers are accurately recorded
• Strong organizational and time-management skills to balance multiple mid-stay policy changes and time-sensitive payor notifications simultaneously
• Able to work a hybrid schedule of 4 days/week in our Nashville office and located within 75 minutes' commuting distance of the office

Benefits

Charlie Health is pleased to offer comprehensive benefits to all full-time, exempt employees. Read more about our benefits here.

Our Values

• Connection: Care deeply & inspire hope.
• Congruence: Stay curious & heed the evidence.
• Commitment: Act with urgency & don't give up.