Preauthorization Specialist

3 hours ago

Newton, Massachusetts, United States Mass General Brigham Full time
Job Summary:

As a Preauthorization Specialist at Mass General Brigham, you will play a critical role in ensuring timely and accurate financial reimbursement for high-dollar patient care. Under the direction of the Financial Coordinator Supervisor, you will analyze and submit necessary information to insurance companies for approval prior to the patient's date of service. Your collaboration with insurance companies and physician offices will be essential in verifying eligibility and authorization requirements.

Key Responsibilities:

  • Verify insurance eligibility, coverage, and authorization requirements via web or phone with third-party payers.
  • Ensure all possible coverages are created and verified, and discrepancies are resolved.
  • Collect and validate order-related information, including office visits, radiology, and surgical orders.
  • Escalate challenging accounts to team leads to ensure approval prior to patient appointments or surgeries.
  • Collaborate with providers and insurance companies to validate data, collect missing information, and resolve discrepancies.

Qualifications:

  • High school graduate or equivalent; some college preferred.
  • 1-2 years of insurance, third-party payor, or secretarial experience in a healthcare setting required.
  • Medical Terminology required.
  • Strong analytical and communication skills.

  • Preauthorization Specialist

    5 months ago

    Newton, United States Mass General Brigham Full time

    Preauthorization Specialist-(3291708) Description Job Summary: Underthe direction of the Financial Coordinator Supervisor, ensures that all information necessary for properfinancial reimbursement for high dollar patient care is analyzed and submittedto insurance companies for approval prior to the patient’s date of service. Collaborateswith...