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Mangrove Management Partners
Boston, MA, United States
Overview The Authorization Specialist will be responsible for financially securing scheduled surgical procedures undertaken by the Vascular Care Group by verifying insurance eligibility and coverage of incoming patients. Responsibilities Monitoring upcoming surgical cases, procedures and imaging on the physician's calendars Responsible for ident
Job Source: Mangrove Management PartnersBeth Israel Lahey Health
Boston, MA, United States
When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. 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 com
Job Source: Beth Israel Lahey HealthDana-Farber Cancer Institute
Brookline, MA, United States
The Drug Authorization Specialist, with direct supervision of the Prior Authorization Supervisor, is responsible for managing all work related to drug authorizations for all injectable drug treatment plans ordered by Dana Farber Cancer Institute providers using knowledge of payer coverage policies and applies appropriate payer guidelines to all asp
Job Source: Dana-Farber Cancer InstituteDana-Farber Cancer Institute
Boston, MA, United States
Job ID: 39258 Location: 10 Brookline Place West, Brookline, MA 02445 Category: Finance/Accounting Employment Type: Full time Work Location: Remote: occasional time on campus Overview The Drug Authorization Specialist, with direct supervision of the Prior Authorization Supervisor, is responsible for managing all work related to drug auth
Job Source: Dana-Farber Cancer InstituteBeth Israel Lahey Health
Winchester, MA, United States
Job Type: Regular Time Type: Full time Work Shift: Day (United States of America) FLSA Status: Non-Exempt When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. Ensures that all information necessary for proper financial reimbursement for high dollar patient care is analyzed and submitt
Job Source: Beth Israel Lahey HealthNortheast Family Services
Dorchester
Job Description Job Description Northeast Family Services is seeking an experienced masters-level professional to join our growing Massachusetts CBHI team as an I ntake Screener and Authorization Specialist! The Intake Screener and Authorization Specialist manages all aspects of the registration and admissions process for Northeast Family Service
Job Source: Northeast Family ServicesBrigham & Women's Hospital(BWH)
Somerville, MA, United States
What does a Prior Authorization Specialist do? The Prior Authorization Specialist (PAS) is an essential role responsible for facilitating exceptional patient experience, by securing authorizations for all scheduled services related to medical and surgical admissions across entities, including BWH OR procedures, BWFH OR procedures, FXB OR procedure
Job Source: Brigham & Women's Hospital(BWH)Brigham & Women's Hospital(BWH)
Somerville, MA, United States
What does a Prior Authorization Specialist do? The Prior Authorization Specialist (PAS) is an essential role responsible for facilitating exceptional patient experience, by securing authorizations for all scheduled services related to medical and surgical admissions across entities, including BWH OR procedures, BWFH OR procedures, FXB OR procedure
Job Source: Brigham & Women's Hospital(BWH)Norwood, MA, United States
Equal Opportunity Employer/Disability/Veterans
This is a full-time remote opportunity. To qualify for this position, you must reside within the Commonwealth of MA or the state of CT
About Reliable Respiratory
Reliable Respiratory is a Durable Medical Equipment (DME) company that provides the highest quality level of service for patients in need of respiratory, diabetes, urology, and maternity support. Equipment provided includes, CPAPs, BiPAPs, AutoPAPs, nebulizers, oxygen equipment, ventilators, CGM devices, insulin pumps, and breast pumps.
Each patient is treated with professionalism, understanding, and attentive service. We care about our customers, work closely with the medical community, and have highly skilled staff ready to assist customers in receiving the best care possible.
The Authorization Specialist reviews all active rentals, and future claims, to assure proper documentation, prior authorization, and patient eligibility are met to achieve successful payment of claims. This position specifically supports the diabetes product line.
Duties and Responsibilities
Review DME rentals to ensure they are renting properly
Responsible for the overall health of the DME accounts that are on hold
Run regular reports on the status of the DME accounts
Verify insurance eligibility updates and changes on patients, including contacting payers to investigate and verify the terms and benefits of patients’ insurance policies as well as patient cost
Research and correct invalid or incorrect patient demographics, insurance inaccuracies, and prescriptions
Facilitate process for requesting Medical Authorizations and Prior Authorizations for Commercial, Medicaid, and Medicare claims. This includes providing guidance to Physicians and patients regarding documentation required for payer coverage, supporting with appeals for denied claims and following up with payer to determine outcome
Assists patients with questions or concerns regarding their account, i.e. billing, documentation requirements, and compliance requirements
Evaluate and escalate “at risk” accounts that do not meet insurance or provider guidelines
Review and obtain updated CMNs for various DME equipment
Verify equipment scheduled to be returned or picked up, to assure appropriate billing to patient and insurance
Analyze monthly rentals that are on manual hold to resume billing activity
Participate in accounts receivable projects
Participate in standing meetings as necessary
Perform other duties and special projects as assigned and directed
Basic Qualifications 18 year of age or older
Must be eligible to work in the United State and not require work authorization from us now or in the future
High School diploma or equivalent required
Experience utilizing HICFA 1500 forms and corresponding EOBs preferred
Required Skills Effective and professional verbal and written communication abilities
Great customer service skills
Professional computer experience (especially Microsoft Office Suite)
Ability to work independently to investigate and make decisions
Strong attention to detail
Ability to prioritize and complete work amidst interruptions in a busy work area
Available during normal hours of operation
Ability to comply with guidelines both internal and industry-imposed
Bilingual in English and Spanish preferred
Competencies Computer Skills
Customer Service
Ethics
Organization Skills
Productivity
Results Driven
Work Environment & Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to communicate and convey information with the appropriate parties. The job requires assuming a stationary position for long periods of time
This role routinely uses standard office equipment such as computers, phones, and printers/scanners
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. This job operates in a professional office environment
The noise level in the work environment is usually moderate to loud
Direct Reports – None
Reliable Respiratory, INC participates in E-Verify. E-Verify is a web-based system that allows an employer to determine an employee's eligibility to work in the US using information reported on an employee's Form I-9. The E-Verify system confirms eligibility with both the Social Security Administration (SSA) and Department of Homeland Security (DHS). For more information, please go to the USCIS E-Verify website.
Email Alert for Authorization Specialist jobs in Norwood, MA, United States
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