Prior Authorization Specialist, Neurology
Job Location:
Boston, MA - USA
Hourly Salary:
Posted:
Application Deadline:
Vacancies:
Job Summary
Mass General Brigham relies on a wide range of professionals including doctors nurses business people tech experts researchers and systems analysts to advance our mission. As a not-for-profit we support patient care research teaching and community service striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Job Summary
Department of Neurology Hybrid Schedule Monday - FridayHelp patients access the care they need while building your career in healthcare!
We are seeking a detail-oriented organized and motivated Prior Authorization Specialist II to join our Department of this important role youll help patients navigate insurance requirements coordinate authorizations and referrals and resolve barriers that may delay access to care.
Working alongside providers clinical teams and revenue cycle professionals youll play a key role in ensuring timely authorizations accurate documentation and efficient reimbursement processes while gaining valuable experience in a specialized healthcare environment.
What Youll Do
- Manage insurance authorizations referrals and eligibility verification ensuring timely processing and accurate documentation in Epic.
- Coordinate with insurance companies specialty pharmacies providers and clinical teams to obtain necessary approvals and supporting documentation.
- Independently manage complex high-cost and time-sensitive authorization requests escalating issues when appropriate.
- Monitor and resolve authorization-related denials support reconsiderations and appeals and collaborate with billing and revenue cycle teams to address reimbursement barriers.
- Communicate with patients regarding authorization status insurance requirements and next steps to help prevent delays in care.
- Review payer policies coverage guidelines and provider schedules to identify and address potential insurance or authorization issues.
- Maintain accurate records manage work queues and identify opportunities to improve workflows and reduce authorization delays.
- Serve as a resource for authorization and referral questions support training of new team members and collaborate across departments to ensure efficient operations.
Qualifications
- High school diploma or equivalent required.
- 23 years of experience in medical authorizations or a related field required.
- Previous Epic experience preferred.
- Knowledge of medical terminology insurance benefits coordination of benefits and authorization processes.
- Strong computer proficiency organizational skills and exceptional attention to detail.
- Excellent communication and interpersonal skills with the ability to navigate complex insurance-related issues.
- Ability to work independently and collaboratively while managing competing priorities in a fast-paced environment.
Additional Job Details (if applicable)
- Hybrid work arrangement
- Comprehensive benefits including medical dental and vision coverage
- 403(b) retirement plan
- Tuition reimbursement
- Discounted MBTA pass and additional employee perks
- Role-specific career growth opportunities
- Opportunity to develop specialized expertise in prior authorizations insurance operations and revenue cycle management
- Collaborate with multidisciplinary teams dedicated to improving patient access to neurological care
- Gain valuable experience managing complex insurance processes and contributing to operational improvements
Youll play an important role in helping patients access the neurological care they need while building valuable expertise in healthcare operations. Join a team where your problem-solving skills attention to detail and commitment to exceptional patient service make a meaningful impact every day!
Remote Type
Work Location
Scheduled Weekly Hours
Employee Type
Work Shift
Pay Range
$22.22 - $31.71/HourlyGrade
4EEO Statement:
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.
Required Experience:
IC
About Company
Patients at Mass General have access to a vast network of physicians, nearly all of whom are Harvard Medical School faculty and many of whom are leaders within their fields.
