Insurance/Authorization Review

Job description

Site: Newton-Wellesley Hospital 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 Location: 159 Wells Ave, Newton, MA Hours: 8:00 am to 4:30 pm Help patients navigate the insurance authorization process while supporting timely, accurate reimbursement for medical services. In this role, you’ll work closely with patients, healthcare providers, and insurance companies to obtain and review authorizations, clarify coverage, and help resolve authorization issues. This position does not involve direct patient care. What You’ll Do • Verify insurance coverage for services, procedures, and treatments to confirm they are covered under the patient’s insurance plan. • Collect and update patient insurance information, including policy numbers, effective dates, and authorization details. • Work with insurance companies to obtain or clarify authorizations, including pre-approvals and pre-certifications. • Partner with billing and coding staff to support accurate, timely claim submissions. • Coordinate prior authorizations for procedures, tests, surgeries, and other services requiring approval. • Review authorization-related insurance denials, gather supporting documentation, and collaborate with healthcare providers on appeals and resubmission of authorization requests as needed. • Help patients understand their insurance coverage, benefits, and authorization requirements. Qualifications What You’ll Bring Education and Experience • High school diploma or equivalent required. • Associate’s degree in Healthcare Management or a related field preferred. • Experience cannot substitute for the required education. • 2–3 years of healthcare insurance billing experience 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, including the ability to explain 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) Why Join Mass General Brigham? Our employees are our most important resource. We offer a comprehensive, contemporary, and highly competitive benefits package designed to support you and your family, including: Medical, dental, and vision insurance A robust retirement savings program Generous paid time off Tuition assistance and professional development support Additional employee perks Ready to make a difference? Join a supportive team where your work helps create an exceptional experience for patients every day. Come be part of the world’s most powerful force in medicine—where every role matters in changing lives. Remote Type Onsite Work Location 159 Wells Avenue Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $21.00 - $25.28/Hourly Grade 2 At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: 4100 Newton-Wellesley Hospital is an Equal Opportunity Employer. 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. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642. 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.