Job Closed
This listing is no longer active.
Mass General Brigham connects a full spectrum of care across a system of academic medical centers, specialty and community hospitals, physician networks, a heal
Insurance/Authorization Review
Location
United States
Posted
61 days ago
Salary
$25 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
Insurance/Authorization Review
Mass General Brigham
Role Description Under the direction of the Financial Coordinator Supervisor, ensures that all information necessary for proper financial reimbursement for high dollar patient care is analyzed and submitted to insurance companies for approval prior to the patient’s date of service. Collaborates with insurance companies and physician offices when necessary to verify eligibility and authorization requirements to ensure financial reimbursement for services. - Perform all insurance verification for eligibility, coverage, and authorization requirements via Web or phone with third party payers. - Ensures all possible coverages are created and verified, through electronic or manual methods, and all discrepancies are resolved. - Validates that coverages are assigned to appropriate visit. - Collects and validates order-related information including office visit, radiology and surgical orders. - Follows up with ordering provider to verify CPT codes. - Escalates challenging accounts to team lead to ensure accounts are approved at prior to patient appointment/surgery. - Escalates non-certified urgent cases to appropriate clinical departments and leadership for approval to proceed or communicate rescheduling. - Contacts providers and insurance companies to validate data, collect missing information and resolve information discrepancies. - Understands clinical guidelines for payors requiring authorization to better build cases for authorization requests and provide feedback to clinical departments on required notes. - Work closely with physician offices obtaining authorization for inpatient and outpatient services. - Work collaboratively with Case Management for all patients’ financial issues and updating accounts. Qualifications - High school graduate or equivalent; some college preferred. - 1-2 years of insurance, third party payor or secretarial experience in a health care setting required. - Medical Terminology required. - Analytical ability to gather and interpret data and communicate desired outcomes orally and in writing in a professional manner. - Strong communication and interpersonal skills. - Ability to handle multiple duties. Requirements - Remote Type: Remote. - Work Location: 2014 Washington Street. - Scheduled Weekly Hours: 40. - Employee Type: Regular. - Work Shift: Day (United States of America). - Pay Range: $ - $25.28/Hourly. - Grade: 2. Benefits - Comprehensive benefits. - Career advancement opportunities. - Differentials, premiums, and bonuses as applicable. - Recognition programs designed to celebrate your contributions and support your professional growth. Company Description 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.
Related Guides
Related Categories
Related Job Pages
More Insurance Jobs
• Identify client needs and recommend tailored insurance solutions • Develop and maintain strong client relationships • Generate leads through networking, referrals, and company-provided resources • Educate clients on available policies and coverage options • Follow up with prospects to close sales and maintain customer satisfaction • Stay informed about industry trends and product offerings • Work independently while collaborating with a supportive team
• Consult with clients to assess their insurance needs and recommend coverage • Educate clients on policy options and help them make informed decisions • Manage the full sales cycle from prospecting to closing deals • Maintain relationships with clients and provide ongoing policy support • Stay up to date with industry trends and product knowledge
Health Insurance Specialist
Entrepreneur CooperativeConnect, Collaborate, Thrive: Dive into ECo's global network of entrepreneurs, fostering connections and collaboration.
• Claims & Insurance Follow-Up: Open claims with Medi-Cal, Medicare, VA, medical groups, and commercial insurance providers for personal injury cases. • Monitor and resolve claim-related issues to ensure timely collection of documentation. • Maintain ongoing follow-up with all applicable insurance providers until every lien is fully resolved at the time of case settlement or closure. • Communicate with insurance carriers to verify treatment details, payments, and claim status. • Lien Review & Dispute Support: Thoroughly review medical bills and verify health insurance liens against treatment records and payments. • Identify discrepancies, invalid charges, or missing information. • File disputes to add or remove charges as needed. • Review medical records and bills in the file to support dispute submissions. • Case Coordination & Internal Support: Coordinate with the case management team to obtain missing reports, invoices, or documentation. • Collaborate with attorney teams to ensure tasks are handled accurately and on time. • Serve as the primary point of contact for health insurance-related inquiries across the firm. • Provide guidance to team members on complex lien-related issues. • Client & Administrative Support: Engage clients to gather required details or documents when necessary. • Maintain accurate records, documentation, and case updates. • Perform other related duties as assigned.
Role Description Our Client is seeking a highly organized, dependable, and patient-focused Remote Dental Insurance & Billing Coordinator to join their growing team. This role is ideal for someone who thrives in a fast-paced healthcare environment and enjoys helping patients understand their insurance coverage and treatment costs. - Insurance Verification & Pre-Authorization Handling - Verify patient insurance eligibility and benefits, process pre-authorizations, and ensure accurate insurance documentation. - Patient Financial Inquiries - Assist patients in understanding insurance coverage, treatment estimates, and expected out-of-pocket costs for various treatment plans. - Billing Assistance & Administrative Support - Support billing-related processes, maintain organized records, and assist with administrative tasks to ensure smooth daily operations. - Additional Responsibilities - Perform front desk and receptionist support tasks when needed. - Manage inbound and outbound patient calls professionally. - Provide patient scheduling and appointment support. - Handle email and phone call management, including voicemail follow-ups. - Send out X-ray results and other patient communications. - Assist with scheduling backup and patient coordination. - Maintain a positive, professional, and patient-centered experience at all times. Qualifications - Dental industry experience is highly preferred. - Insurance verification and billing expertise. - Knowledge of insurance plans and out-of-pocket cost calculations preferred. - Familiarity with Open Dental practice management system preferred, or the ability to learn quickly as the clinic transitions from Egosap. - Strong phone communication skills. - Patient-facing customer service experience. - Ability to manage multiple insurance-related inquiries efficiently. - Professional demeanor and excellent interpersonal skills for patient interactions. Requirements - Must be proficient in speaking and writing English very clearly. - Must have relevant work experience. - Be able to submit an NBI clearance and/or Local Police Clearance background check before onboarding (mandatory). - Must be available for video meetings with your camera on (when needed). - Device: Reliable laptop or desktop computer. - Internet: High-speed connection (minimum 10 Mbps). - Audio: Noise-canceling headset. - Video: Webcam for virtual meetings. - Workspace: Quiet, professional environment. Benefits - Dedicated HR & Contractor Support Team: Access to world-class support for questions, guidance, contract matters, and client communication. - Premium VPN Access (Optional): A secure VPN license can be provided upon request to enhance privacy and security for client-related tasks. - HIPAA & Cybersecurity Training + Certification (Provided): Access to our internal HIPAA compliance training, cybersecurity modules, and certification to help you confidently handle PHI for U.S. healthcare clients. - Top 1% VA Performance Training: Access to our proprietary training on communication, client management, productivity systems, and best practices to help you become a top-performing VA and increase long-term client retention. - Client-Approved U.S. Holidays: Contractors may take U.S. holidays off according to the client’s needs and schedule. - Client-Approved Paid or Unpaid Time Off: Time off may be granted by your client. Paid time off is optional and only if offered by the client. - Access to Tools & Resources: Templates, workflow guides, productivity tools, and client-specific SOP support to help you perform at your best. - Optional Performance-Based Incentives: Some clients may offer bonuses, incentives, or increased hours based on your performance.


