Job Description:
Site: The General Hospital Corporation
At Mass General Brigham, we know it takes a surprising range of talented professionals to advance our mission-from doctors, nurses, business people and tech experts, to dedicated researchers and systems analysts. As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve.
At Mass General Brigham, we believe a diverse set of backgrounds and lived experiences makes us stronger by challenging our assumptions with new perspectives that can drive revolutionary discoveries in medical innovations in research and patient care. Therefore, we invite and welcome applicants from traditionally underrepresented groups in healthcare - people of color, people with disabilities, LGBTQ community, and/or gender expansive, first and second-generation immigrants, veterans, and people from different socioeconomic backgrounds - to apply.
Monday through Friday 8:30am-5pm
Mandatory in office the first 90-day for in person training.
Remote considered after successful completion of training and meeting job requirements.
Job Summary
Summary Responsible for managing the insurance authorization process by working closely with patients, healthcare providers, and insurance companies to obtain and review insurance authorizations for medical services, ensuring accurate and timely reimbursement.
Essential Functions Verify insurance coverage for specific services, procedures, or treatments, ensuring that the services provided are covered by the patient's insurance plan.
-Collect and update patient insurance information, including policy numbers, effective dates, and authorization details.
-Collaborate with insurance companies to obtain or clarify insurance authorizations, including pre-approvals and pre-certifications.
-Collaborate with billing and coding staff to ensure that claims are submitted accurately and in a timely manner.
-Facilitate the prior authorization process for procedures, tests, surgeries, and other services requiring pre-authorization.
-Review insurance denials related to authorization issues, gather supporting documentation, and collaborate with healthcare providers to develop appeals and resubmit authorization requests as necessary.
-Assist patients in understanding their insurance coverage, benefits, and authorization requirements.
Qualifications
Education
High School Diploma or Equivalent required or associate's degree Healthcare Management preferred, or associate's degree Related Field of Study preferred
Experience
Healthcare Insurance Billing Experience 2-3 years required
Knowledge, Skills and Abilities
- Strong knowledge of insurance verification, claims processing, and reimbursement practices.
- Understanding of insurance coverage, benefit structures, and claim submission requirements.
- Excellent attention to detail and accuracy in data entry, documentation, and claim submissions.
- Effective communication and interpersonal skills, with the ability to communicate complex insurance and billing concepts to patients and healthcare providers.
- Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.
Additional Job Details (if applicable)
Physical Requirements
Remote Type
Onsite
Work Location
1620 Tremont Street
Scheduled Weekly Hours
40
Employee Type
Regular
Work Shift
Day (United States of America)
EEO Statement:
The General Hospital Corporation is an Affirmative Action Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.
Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
More jobs in Boston, Massachusetts
|
Cribl
$128,300.00 - $170,000.00 per year
|
|
Environmental Resources Management Inc |
|
Athleta
$0.00 - $100.00 per hour
|