Authorization Specialist

3 months ago

Boston, United States Mangrove Management Partners Full time

Overview

The Authorization Specialist will be responsible for financially securing scheduled surgical procedures undertaken by The Vascular Care Group by verifying insurance eligibility and coverage of incoming patients.

This role will report to the Manager of Revenue Cycle.

Responsibilities

  • Monitoring upcoming surgical cases, procedures and imaging on the physician's calendars
  • Responsible for identification and authorization of all codes that may be used throughout complex and variable patient treatments
  • Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms necessary information to allow processing of claims to insurance plans
  • Collaborates with other departments to ensure documentation is received prior to services
  • Assists with medical necessity documentation to expedite approvals and ensure the appropriate follow-up
  • Accurately completes cost analysis form, documenting the required cost estimation for collection prior to services
  • Documents authorizations and progress of authorizations in the patient's chart
  • Ensures all updates to documentation in client's file are completed in a timely manner
  • Participate in providing ongoing training and education of staff as it relates to new processes to ensure timely confirmation of surgical cases
  • Ensures compliance with appropriate industry regulations and State and Federal regulations
  • Safeguard strict confidentiality of all health records, member information and meet HIPAA guidelines
  • Performs other duties as assigned
Requirements
  • Bachelor's degree preferred
  • 1+ years of surgical insurance verification experience required
  • Vascular experience preferred
  • Working knowledge of eligibility, verification of benefits, and prior authorizations from various HMOs, PPOs, commercial payers and other funding sources
  • Proficiency in establishing good working relationships with both internal and external vendors/customers, both in person and over the phone
  • Outstanding written and verbal communication skills, with close attention to detail
  • Demonstrated ability to analyze data and work independently within a fast-paced work environment
  • Proficiency in technology, in particular Microsoft Office Suite
  • Excellent organizational and prioritization skills


#Mangrove

  • Pharmaceuticals Specialist

    1 week ago

    Boston, Massachusetts, United States Lifelancer Full time

    Unlock Your Potential as a Pharmaceutical SpecialistWe are seeking a skilled Pharmaceuticals Specialist to join our dynamic team. In this role, you will play a crucial part in evaluating and reviewing prior authorization requests, ensuring that patients receive the medications they need.About the JobThis is a remote position requiring active pharmacist...

  • Prior Authorization Specialist I

    4 weeks ago

    Boston, United States Roslindale Full time

    Full Time POSITION SUMMARY: Responsible for screening prior-authorization and coordination of specialized services requests in the medical care management program, including a broad range of requests for inpatient, outpatient and ancillary services. Adheres to policies and procedures in order to comply with performance and compliance standards and to ensure...

  • Technical Operations Specialist

    1 week ago

    Boston, Massachusetts, United States Massachusetts Port Authority Full time

    Job SummaryWe are seeking a skilled Help Desk Manager to join our team at the Massachusetts Port Authority. The successful candidate will be responsible for coordinating tasks, reviewing work, and fostering collaboration to ensure efficient Help Desk operations.About UsThe Massachusetts Port Authority is a dynamic organization that connects people and...

  • Desktop Support Specialist

    6 months ago

    Boston, United States Indotronix International Corporation Full time

    Title: Desktop Support Specialist Location: 1 Marina Park Drive, Boston, MA 02210 12 Months contract RESPONSIBILITIES: • Maintains, analyzes, troubleshoots, and repairs computer systems, hardware and computer peripherals. • Documents, maintains, upgrades or replaces software systems. • Supports and maintains user account information including...

  • Customer Service Specialist

    3 months ago

    Boston, United States AdaptHealth LLC Full time

    Job Type Full-time Description AdaptHealth Opportunity - Apply Today! At AdaptHealth we offer full-service home medical equipment products and services to empower patients to live their best lives - out of the hospital and in their homes. We are actively recruiting in your area. If you are passionate about making a profound impact on the quality of patients'...

  • Financial Clearance Specialist I

    2 weeks ago

    Boston, United States Massachusetts General Physicians’ Organization Full time

    Job Description - Financial Clearance Specialist I - 90 days onsite and Remote After Successful Training (3310293)Under general supervision of the Financial Clearance Manager, the Financial Clearance Specialist I functions as primary interface between MGH Imaging, MGH Patient Service Center, insurance companies, patients, and referring practices. The...

  • Financial Clearance Specialist I

    2 weeks ago

    Boston, United States Massachusetts General Physicians’ Organization Full time

    Job Description - Financial Clearance Specialist I - 90 days onsite and Remote After Successful Training (3310293)Under general supervision of the Financial Clearance Manager, the Financial Clearance Specialist I functions as primary interface between MGH Imaging, MGH Patient Service Center, insurance companies, patients, and referring practices. The...

  • Training Specialist

    4 days ago

    Boston, United States Bay Cove Human Services Full time

    Training Specialist - Training DepartmentBoston, MA, USA Req #3091Wednesday, December 4, 2024Bay Cove Human Services' mission is to partner with people to overcome challenges and realize personal potential. Bay Cove pursues this mission by providing individualized and compassionate services to people facing the challenges associated with developmental...

  • Digital Outreach Specialist

    1 week ago

    Boston, Massachusetts, United States beBee Full time $1,000 - $20,000 per month

    About the RoleWe are looking for a skilled Link Building Specialist to join our team at beBee. As a key member of our digital outreach team, you will be responsible for developing and implementing link building strategies to enhance our online presence.Key Responsibilities:Develop and execute link building strategies to improve our search engine...

  • Senior Risk Management Specialist

    2 weeks ago

    Boston, Massachusetts, United States AIG Full time

    About the RoleAIG's Underwriting team is seeking a highly skilled and experienced Senior Risk Management Specialist to join their team in Jersey City, NJ or New York City, NY.Key Responsibilities:- Assist in the development and implementation of comprehensive quality assurance and market conduct review processes.- Conduct reviews of all Programs, either...

  • Housing and Community Development Specialist

    3 weeks ago

    Boston, Massachusetts, United States Commonwealth of Massachusetts Full time

    Job SummaryThe Commonwealth of Massachusetts is seeking a highly skilled Housing/Conversion Specialist to join our team in the Division of Housing Development.This role plays a critical part in implementing the Conversion to Residential Fund (CTRF) authorized by the Affordable Homes Act of 2024.Main Responsibilities:Develop guidelines, application forms, and...

  • Documentation Specialist

    1 month ago

    boston, United States Insight Global Full time

    Position: Documentation SpecialistLocation: 316 Northern Ave, Boston, MA - HYBRID (3x onsite can choose which days)Pay: $40-60/hr (2 openings - Mid-Level & Senior Levels)Start Date: 1/2/2025Day-to-Day:The Senior Specialist is responsible for performing multiple activities in support of their group or clients under minimal supervision. The Senior Specialist...

  • Documentation Specialist

    1 month ago

    Boston, United States Insight Global Full time

    Position: Documentation SpecialistLocation: 316 Northern Ave, Boston, MA - HYBRID (3x onsite can choose which days)Pay: $40-60/hr (2 openings - Mid-Level & Senior Levels)Start Date: 1/2/2025Day-to-Day:The Senior Specialist is responsible for performing multiple activities in support of their group or clients under minimal supervision. The Senior Specialist...

  • Documentation Specialist

    4 weeks ago

    Boston, United States Insight Global Full time

    Position: Documentation SpecialistLocation: 316 Northern Ave, Boston, MA - HYBRID (3x onsite can choose which days)Pay: $40-60/hr (2 openings - Mid-Level & Senior Levels)Start Date: 1/2/2025Day-to-Day:The Senior Specialist is responsible for performing multiple activities in support of their group or clients under minimal supervision. The Senior Specialist...

  • Regulatory Affairs Director, Global CMC Specialist

    1 week ago

    Boston, Massachusetts, United States Takeda Pharmaceutical Full time

    About the Role:Takeda Pharmaceutical is a patient-focused company committed to delivering Better Health and a Brighter Future to people around the world.We are seeking an experienced Regulatory Affairs Director, Global CMC Specialist to oversee the development and execution of regulatory CMC strategies for our pharmaceutical products.This role requires a...

  • Senior MES Automation Specialist

    1 week ago

    Boston, Massachusetts, United States Skellig Full time

    Job Overview:Skellig is seeking a highly skilled Senior MES Automation Specialist to support our clients across North America. The ideal candidate will have experience with PAS-X and cGMP processes and be able to lead small to large teams to complete automation projects.Key Responsibilities:• Design, configure, implement, and test changes for new and...

  • SEO Specialist

    1 week ago

    Boston, Massachusetts, United States beBee Full time $1,000 - $20,000 per month

    Job OverviewWe are searching for a freelance Link Building Specialist who will play a crucial role in enhancing our SEO strategy and boosting our online presence.Key Responsibilities:Formulate and execute impactful link building strategies to improve our search engine rankings.Seek out link opportunities on high-authority domains to increase our online...

  • Flooring Installation Specialist

    2 weeks ago

    Boston, Massachusetts, United States CentiMark Corporation Full time

    Job Summary:We are seeking a highly skilled Flooring Installation Specialist to join our team at CentiMark Corporation.Responsibilities:Install polished concrete, epoxy, urethane, and hard surface flooring systemsEnsure strict compliance with all health and safety rules and regulationsProper use of equipment and materialsStrive to meet and exceed any and all...

  • SEO Specialist

    3 weeks ago

    Boston, Massachusetts, United States beBee Full time $1,000 - $20,000 per month

    Job OverviewWe are searching for a freelance Link Building Specialist who will play a crucial role in enhancing our SEO strategy and boosting our online presence.Key Responsibilities:Formulate and execute impactful link building strategies to improve our search engine rankings.Seek out link opportunities on high-authority domains to increase our online...

  • Clinical Ambulatory Nurse Specialist

    1 week ago

    Boston, Massachusetts, United States Mass General Brigham Full time

    About the RoleWe are seeking a skilled Clinical Ambulatory Nurse Specialist to join our team at Mass General Brigham in Boston, Massachusetts.Job SummaryUnder the supervision of the Nursing Director and Medical Director, this role will provide patient-centered nursing care in the ambulatory care setting. The ideal candidate will collaborate with attending...