Pre-Authorization specialist
5 days ago
The Pre-Authorization Specialist II is responsible for performing proficient benefit verification and pre-authorization functions with insurance carriers, within an established time frame, for new pre-surgical cases submitted to the Pre-Authorization Support Department.
Responsibilities will include:
Checking the departmental electronic inbox to coordinate the initial intake of physician and facility requests to secure prior authorization for service
Create electronic folders for new patients
Organize patient medical records in preparation for prior authorization and appeals process
nswers incoming calls received through the toll-free Pre-Authorization Support ACD and provides appropriate call/case handling
Performs benefit verification, pre-surgical authorization for new pre-surgical cases, and appeals by working closely with all payers
Utilizes proficient knowledge in Microsoft Office and database management to document case status, actions, and outcome
Communicates and builds relationships with HCP offices and Field Reimbursement Managers in regard to all inquiries for the handling of cases, i.e., missing case information, benefits, etc.
Utilizes customer service skills in engaging with customers, communicating with sales representatives, and working in teams in a call center environment to expedite processing of cases
Coordinates with lead and supervisor regarding complicated cases
Quality Systems Duties and Responsibilities:
Build Quality into all aspects of their work by maintaining compliance to all quality requirements.
Required qualifications:
High School Diploma
Minimum 2-3 years of recent Insurance Pre-Authorization experience. Must have recent experience
Experience working with various payors including, Medicare, Medicaid, and Private Payor, as it relates to medical procedures, services, and devices
Experience building effective relationships with internal and external customers.
-
Pre-Authorization Specialist II
1 week ago
Marlborough, Massachusetts, United States Adecco US, Inc. Full timeAdecco US, Inc. is seeking a highly skilled Pre-Authorization Specialist II to join our team.The ideal candidate will have a minimum of 2-3 years of recent insurance pre-authorization experience and be proficient in working with various payors, including Medicare, Medicaid, and private payors.The Pre-Authorization Specialist II will be responsible for...
-
Administrative Assistant II
2 weeks ago
Marlborough, Massachusetts, United States Adecco US, Inc. Full timeJob Title: Pre-Authorization Specialist IIAdecco US, Inc. is seeking a highly skilled Pre-Authorization Specialist II to join our team. As a key member of our Pre-Authorization Support Department, you will be responsible for performing benefit verification and pre-authorization functions with insurance carriers.Responsibilities:Coordinate the initial intake...
-
Administrative Assistant II
2 weeks ago
Marlborough, Massachusetts, United States Adecco US, Inc. Full timeJob Title: Pre-Authorization Specialist IIAdecco US, Inc. is seeking a highly skilled Pre-Authorization Specialist II to join our team. As a key member of our Pre-Authorization Support Department, you will be responsible for performing proficient benefit verification and pre-authorization functions with insurance carriers, within an established time frame,...
-
Patient Service Representative
3 months ago
Marlborough, United States Hartford Healthcare Full timeDescription Job Schedule: Per Diem Standard Hours: 1 Job Shift: Shift 1 Shift Details: Variable during hours of operation, 7am to 7pm Work where every moment matters.Every day, almost 20,000 Hartford HealthCare employees come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of...
-
IT Infrastructure Specialist
1 week ago
Marlborough, Massachusetts, United States Diverse Lynx Full timeJob SummaryWe are seeking a highly skilled IT Infrastructure Specialist to join our team at Diverse Lynx LLC. The successful candidate will be responsible for maintaining and operating on-premise and cloud IT infrastructure components and services, including monitoring IT infrastructure and computer networks for errors, malfunctions, and security...
-
Wireless Sales Specialist
2 weeks ago
Marlborough, Massachusetts, United States Russell Cellular, Inc. Full timeWhy Russell CellularAt Russell Cellular, we offer a competitive compensation package, including up to $20 hourly pay, unlimited commissions, and a comprehensive benefits program.We are committed to providing our customers with the best wireless experience possible, and we're looking for a motivated and customer-focused individual to join our team as a...
-
Patient Safety Specialist
3 weeks ago
Marlborough, Massachusetts, United States UMass Memorial Health Care Full timeJob SummaryUMass Memorial Health is seeking a highly skilled Patient Safety Specialist to join our team. As a key member of our quality improvement team, you will play a critical role in ensuring the highest level of patient safety and quality care across our healthcare system.Key ResponsibilitiesParticipate in the coordination, implementation, and...
-
Care Manager
2 weeks ago
Marlborough, Massachusetts, United States US01 AllCare Plus Pharmacy, Inc. Full timeJob Title: Care Manager - Medical Billing/Insurance SpecialistAt US01 AllCare Plus Pharmacy, Inc., we are seeking a highly skilled Care Manager to join our team. As a Care Manager, you will be responsible for contacting insurance companies to obtain correct eligibility information, performing benefit investigations, and assisting patients with copay...
-
Sales - Wireless Specialist
3 months ago
Marlborough, United States Russell Cellular, Inc. Full timeWhy Russell Cellular ? Starting pay is up to $20 hourly! • Unlimited Commissions • Health, dental, vision, and life insurance • Paid sick days and company holidays • Employer matched 401K • Listed in Inc. 5000's Fastest Growing Private Companies in America for 9 consecutive years and inducted into the Inc. Hall of Fame in 2018 • Employee...
-
Sr. Customer Relations Specialist
3 months ago
Marlborough, United States ApiTech Full time** Sr. Customer Relations Specialist** **Job Category****:** Customer Service **Requisition Number****:** SRCUS03521 Showing 1 location **Job Details** **Description** JOB **SUMMARY:** The Sr. Customer Relations Specialist will be responsible to provide and nurture customer relations activities between customer and company, sales, sales representatives,...
-
Customer Relations Specialist
1 month ago
Marlborough, Massachusetts, United States ApiTech Full timeJob SummaryThe Sr. Customer Relations Specialist will be responsible for fostering and maintaining strong relationships between customers and the company, sales, sales representatives, operations, and engineering teams. This role involves processing customer inquiries and requests, providing quotes and delivery information, and following up with customers...
-
Career Development Specialist
4 days ago
Marlborough, Massachusetts, United States MassHire Metro SouthWest Workforce Board Full timeJob Summary:The MassHire Metro SouthWest Workforce Board seeks a highly motivated and experienced Career Development Specialist to join our team. As a key member of our Youth Connections team, you will be responsible for implementing our Virtual Reality Program within schools and community-based organizations, facilitating workshops, and conducting intake...
-
Wireless Sales Representative
4 weeks ago
Marlborough, Massachusetts, United States Russell Cellular, Inc. Full timeUnlock Your Potential as a Wireless Sales SpecialistRussell Cellular, Inc. is a leading Verizon Authorized Retailer seeking a highly motivated and customer-focused Wireless Sales Specialist to join our team. As a key member of our sales team, you will play a vital role in delivering exceptional customer experiences and driving sales growth.Key...
-
Facilities Engineer
2 weeks ago
Marlborough, Massachusetts, United States RTX Full timeJob Title: Facilities Engineer - Electrical Systems SpecialistJob Summary:We are seeking a highly skilled Facilities Engineer - Electrical Systems Specialist to join our team at RTX. The successful candidate will be responsible for supporting facilities electrical design, electrical distribution, and construction project management.Key...
-
Medical Specialist
1 week ago
Marlborough, Massachusetts, United States Metrowest Medical Center Full timeAt Metrowest Medical Center, we are seeking a skilled Physician to join our team. As a key member of our healthcare team, you will be responsible for providing high-quality patient care and services consistent with accepted medical practices and accreditation standards.Key Responsibilities:Providing health care services to patientsCollaborating with other...
-
Early Childhood Educator
2 weeks ago
Marlborough, Massachusetts, United States Amal Alliance Full timeJob Title: Childhood SpecialistAmal Alliance is seeking a highly skilled and dedicated Childhood Specialist to join our team. As a key member of our Mobile Learning Initiative, you will play a vital role in providing high-quality early childhood programming to under-school-age children in a fully mobile learning environment.About the RoleThe Childhood...
-
Electronics Specialist
4 weeks ago
Marlborough, Massachusetts, United States CyberCoders Full timeJob Title: Electronics TechnicianWe are a leading global consumer products company offering creative products and solutions for our customers through a diversified portfolio of well-recognized and widely-trusted brands.Job Summary:The Electronics Technician is responsible for conducting tests to ensure compliance with agency standards, reviewing test data...
-
Software Development Specialist
1 month ago
Marlborough, Massachusetts, United States ProKatchers LLC Full timeJob Title: Development EngineerLocation: Marlborough, MADuration: 12 MonthsJob Summary:The Development Engineer plays a crucial role in supporting R&D's Product Development by providing expertise in prototyping, testing, and verification and validation of prototypes, components, and products.Key Responsibilities:Create verification and validation test...
-
Marlborough, Massachusetts, United States Guardian Angel Senior Services Full timeOur Mission: At Guardian Angel Senior Services, we strive to provide exceptional care and support to adults with disabilities, ensuring they live a safe and fulfilling life. We are seeking a skilled Transition Specialist to join our team and make a meaningful difference in the lives of our clients.Job Summary: The Transition Specialist will work...
-
Senior Medical Device Toxicologist
4 weeks ago
Marlborough, United States Boston Scientific Full timeWork mode: HybridOnsite Location(s): Marlborough, MA, US, 01752Additional Location(s): US-MN-Arden Hills; US-MN-Maple Grove. Diversity - Innovation - Caring - Global Collaboration - Winning Spirit - High PerformanceAt Boston Scientific, we’ll give you the opportunity to harness all that’s within you by working in teams of diverse and high-performing...