Verification and Authorization Specialist

About us:
Forge Health is a mission-driven outpatient mental health and substance use provider dedicated to providing the highest quality, affordable, and effective care to individuals, families, and communities in need. As the first and only behavioral healthcare provider with a proven, national payer-validated ability to drive clinical outcomes that span all areas of health, Forge Health is leading the charge in driving innovation, improving care delivery, and shaping the future of behavioral health care.

At Forge, clinical care is paramount – it’s the heartbeat of our operations and the driving force in everything we do. The skill and compassion of our staff are the crucial components to extraordinary experiences and outcomes for those we serve. With our current clinical footprint in the greater Northeast, we have offices in New York, New Jersey, Pennsylvania, New Hampshire – and we’re growing! Come join us!

Who we're looking for:

We are seeking a detail-oriented and customer-focused Verification and Authorization Specialist with strong payer knowledge and excellent communication skills. The ideal candidate is experienced at verifying coverage and benefits, navigating multiple payer portals, and obtaining prior authorizations. A collaborative approach to working with clinical teams and a commitment to timely, professional communication with clients and staff are essential.

What you'll be doing:

• 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.

What you'll need:

• 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.

Why Forge?

The opportunity:

Our team refuses to compromise on integrity, and we look for talented, driven hard workers who hold the same passion for the pursuit of high quality, evidence-based mental health and substance use care that we do. Our collective passion is driven and embodied by our core values:

• Fulfilling: Our work creates lives that are complete and self-actualized, enabling stronger families and communities – and a therapeutic community rewarded by success
• Optimistic: Our passionate positivity and empathy overcome setbacks and get you to your goals, scientifically and humanely
• Reciprocal: Without mutual trust and commitment, there can be no progress
• Grateful: We profoundly recognize and appreciate the trust of our patients and the commitment of our clinicians
• Evidence-Based: We are committed to measurable outcomes, which provide confidence to our patients and creates a standard of care for ourselves and others

The package:

At Forge, our people are our greatest asset. We’re collaborative, empathetic, and passionate. We learn from our mistakes, we carve out time to breathe, and we are celebrated for our wins. In short, we know that we can’t do what we do without you! So, we designed a comprehensive, competitive benefits package that reflects our appreciation of our people:

• Competitive salary aligned with your experience
• 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
• Dedicated, motivated team and chance to be part of a highly ambitious medical startup
• Modern, elegant, and high-end work environment

Please note: most benefits listed apply to the majority of positions, though eligibility may vary by role, full‑time/part‑time status, and length of service. Specific benefit details and any role‑based exceptions will be provided during the offer stage.

We are committed to equal employment opportunity. We give equal consideration to all applicants when filling positions without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, age, actual or perceived disability, genetic information, marital status, and/or any other status not related to an applicant’s ability to perform the job duties. All employment practices will be carried out in accordance with federal, state and local laws.
We will also fully comply with regulations and requirements set out by the Americans with Disabilities Act (ADA) and the ADA amendments Act (ADAAA). We will not discriminate against applicants or other individuals with real or perceived disabilities. When needed, we will provide reasonable accommodation to otherwise qualified candidates so that they are able to perform the essential functions of the position.