Insurance Authorization Coordinator
2 weeks ago
About Salem Hospital, Inc.
Salem Hospital, an affiliate of Mass General Brigham, is dedicated to enhancing patient care, advancing research, and serving the community. We prioritize diversity, equity, and inclusion to mirror the variety of the patients we support. At Mass General Brigham, we advocate for equal access to quality healthcare and career opportunities, embracing the full spectrum of human diversity, including race, gender, sexual orientation, ability, religion, ethnicity, and national origin.
Position Overview
The Authorization/Pre-Certification Specialist plays a crucial role in ensuring that patient demographics and financial data are accurately recorded in the hospital's registration system. This position involves direct interaction with patients, physician offices, the Central Billing Office, and third-party payers to determine eligibility and secure necessary insurance authorizations and pre-certifications for various admissions and procedures.
Key Responsibilities
- Collaborate with team members to obtain insurance authorizations for elective and emergency admissions and procedures, ensuring all required information is submitted in a timely manner.
- Verify and assign the correct diagnosis and procedure codes to match the secured authorizations.
- Ensure completeness and accuracy of patient demographic and financial information for all types of admissions and outpatient encounters.
- Refer patients to the Financial Counseling Department when financial obligations cannot be met.
- Communicate potential insurance authorization issues to patients and admitting physicians prior to services.
- Document and manage the insurance authorization process using the hospital's registration system to facilitate billing.
- Analyze and address denial trends to enhance hospital revenue, maintaining a low denial error rate.
- Maintain high standards of accuracy and quality in individual assignments while supporting team productivity.
- Adapt to new electronic systems and software, ensuring efficient workflow.
Qualifications
High School Diploma or GED equivalent is required. Candidates must possess strong communication skills, both oral and written, along with excellent organizational abilities and the capacity to multitask. A proactive approach to problem-solving and the ability to work under pressure are essential. Familiarity with computer systems and typing skills (minimum 40 WPM) are also necessary.
Equal Employment Opportunity
Salem Hospital is an Affirmative Action Employer. We are committed to fostering a diverse workforce and ensuring that all qualified applicants receive equal consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, or any other status protected by law.
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Insurance Authorization Coordinator
2 weeks ago
Salem, Massachusetts, United States Salem Hospital, Inc. Full timeAbout Salem Hospital, Inc.Salem Hospital, an affiliate of Mass General Brigham, is dedicated to enhancing patient care, research, education, and community service. We prioritize diversity, equity, and inclusion, aiming to reflect the varied backgrounds of the patients we serve. At Mass General Brigham, we advocate for equal access to quality healthcare,...
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