UR Coordinator

Assembly Health

. Obtain and manage prior authorizations for Spravato and TMS services from commercial and government insurance plans .

Posted 10/22/2026full-timeRemote • United StatesJuniorMid-Level💰 $22 - $25 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing prior authorizations and clinical documentation for Spravato and TMS services, with a strong understanding of medical necessity criteria and payer policies. Capable of coordinating effectively with clinical and administrative teams while maintaining detailed records and managing multiple priorities.

Highest-signal resume keywords

Medical Prior Authorization ExperienceKnowledge Of Medical Necessity CriteriaEHR Systems ProficiencyStrong Communication SkillsBehavioral Health Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Prior Authorization ManagementUtilization ReviewBilling ProcessesClinical DocumentationInsurance Carrier FamiliarityMedical Policy ReviewAuthorization WorkflowsPayer CommunicationSubmission TrackingDenial Management

Soft Skills

Organizational SkillsDetail-OrientedIndependent WorkCollaborative SkillsTime Management

Tools & Technologies

EHR SystemsPayer Portals

Industry Keywords

SpravatoTMS ServicesCMS GuidelinesCommercial Payer GuidelinesMassHealthREMS-Certified ProgramsBehavioral HealthNeuromodulation

About the role

Key responsibilities & impact

Obtain and manage prior authorizations for Spravato and TMS services from commercial and government insurance plans
Ensure timely submission of clinical documentation, including medical necessity letters, progress notes, rating scales, and treatment plans
Review payer-specific medical policies to determine criteria for Spravato and TMS coverage
Coordinate with providers, clinical staff, and billing teams to ensure complete and accurate submissions
Track and follow up on authorization requests, denials, appeals, and renewals
Maintain detailed records of payer communication, submission timelines, and authorizations received
Support new customers during their start-up phase by navigating authorization processes and clinical documentation
Stay current on insurance requirements, payer policies, and clinical documentation standards
Take on additional projects and tasks as assigned

Requirements

What you’ll need

Minimum 2 years of experience in medical prior authorization, utilization review, or billing, preferably in behavioral health or neuromodulation
Strong working knowledge of medical necessity criteria for Spravato and TMS services, including familiarity with CMS, commercial payer, and MassHealth guidelines
Experience with a wide range of insurance carriers, including Massachusetts and Rhode Island-specific carriers
Comfortable working with EHR systems, payer portals, and medical documentation
Proven ability to manage multiple priorities and tight deadlines
Detailed and organized written and verbal communication skills
Ability to work independently and collaboratively with clinical and administrative staff
Preferred experience with in-network and out-of-network authorization workflows
Preferred prior work with REMS-certified treatment programs

Benefits

Comp & perks

Medical insurance
Dental insurance
Vision insurance
401(k)
Paid time off
Opportunity to participate in company bonus programs
Comprehensive benefits package