Financial Access Specialist

0100 Mass General Brigham Incorporated; Somerville (MA); À distance; USD 29 000 - 39 000; Plein temps

Résumé du poste

Mass General Brigham is seeking a Financial Access Specialist to handle financial clearance for post-acute admissions across IRF, LTAC, and SNF levels. The role verifies eligibility, manages prior authorizations, and documents in Epic to support timely admissions.

The position is remote with a quiet, HIPAA‑compliant workstation and occasional weekend shifts. Requires 2+ years in patient access or revenue cycle and strong collaboration with Admissions and Financial Counseling.

Qualifications

• High School Diploma or equivalent required.
• Bachelor’s degree preferred.
• Experience in patient access, hospital registration, or revenue cycle is strongly preferred.

Responsabilités

• Verify insurance eligibility, coverage, and benefits for post-acute admissions.
• Initiate and manage prior authorization requests through final determination.
• Document authorization activity in Epic Auth/Cert.
• Identify financial risks and escalate as needed.
• Collaborate with Admissions, Case Management, and Financial Counseling to ensure timely admissions.

Connaissances

Insurance verification

Prior authorizations

Epic knowledge

Communication skills

Attention to detail

Teamwork

Formation

High School Diploma

Bachelor's degree preferred

Outils

Epic

Description du poste

Job Summary

Under the direction of the Patient Access Manager, the Financial Access Specialist is responsible for financial clearance of assigned post-acute admissions within the Financial Access Department, supporting inpatient Acute Rehabilitation (IRF), Long Term Acute Care (LTAC), and Skilled Nursing Facility (SNF) levels of care across Spaulding Rehabilitation facilities. This role verifies insurance eligibility, coverage, and benefits, and manages prior authorizations from initiation through final determination. The Financial Access Specialist ensures accurate documentation within Epic and works collaboratively with Admissions, Case Management, Financial Counseling, leadership, and other departments to ensure timely admissions and financial accountability aligned with organizational goals and system-wide objectives.

Essential Functions

• Responsible for financial clearance of assigned post-acute admissions, including verification of insurance eligibility, coverage, and benefits.
• Initiates and manages prior authorization requests from submission through final determination. This includes submitting required clinical documentation, conducting routine status checks through payer portals and direct communication with payers, confirming admission and authorization details with payers when applicable, and ensuring timely progression of each case.
• Ensures all authorization activity is thoroughly documented in Epic (Auth/Cert), providing visibility across departments and supporting accurate reimbursement.
• Identifies benefit limitations, network concerns, out-of-network scenarios, and other financial risks, escalating to the Patient Access Manager or Financial Counselor when appropriate.
• Negotiates single case agreements with Workers’ Compensation carriers and non-contracted payers as needed, including preparation of cost estimates and participation in reimbursement discussions to secure appropriate payment terms.
• Responsible for monitoring and prioritizing assigned Epic Workqueues to support time-sensitive admissions and maintain efficient referral throughput.
• Communicates authorization updates, insurance requests for additional information, peer-to-peer offers, appeals, and denials to Admissions and other relevant stakeholders.
• Maintains and resolves errors and required edits within Epic Patient and Account Workqueues, including pre-admission, admitted, and discharged encounters, to ensure account accuracy and appropriate reimbursement.
• Prepares self-pay cost estimates when applicable and collaborates with Financial Counseling to ensure financial clearance prior to admission.
• Accurately records authorization determinations and approval details to support Case Management with continued stay and utilization review activities.
• Works collaboratively with Admissions, Case Management, Financial Counseling, and leadership to support timely and financially appropriate admissions.

Education

High School Diploma or equivalent required Bachelor's degree preferred

Experience

2+ years of experience required in patient access/hospital registration or revenue cycle Epic experience is strongly preferred Experience with prior authorizations and insurance verifications, eligibility and coverage strongly preferred (inpatient or post‑acute experience)

Knowledge, Skills and Abilities

Knowledge of medical terminology, insurance plans, and reimbursement processes. Familiarity with healthcare regulations, including HIPAA, and the ability to maintain patient confidentiality. Excellent communication and interpersonal skills to effectively interact with patients, families, and healthcare professionals. Strong attention to detail and organizational skills to manage multiple requests effectively. Ability to work independently and as part of a team in a fast-paced environment.

Working Schedule

Remote, requires a quiet, secure, HIPAA‑compliant work station Occasional weekends required (one Saturday shift 10am - 2pm monthly, subject to change)

Additional Job Details

• Remote Type Remote
• Work Location 399 Revolution Drive
• Scheduled Weekly Hours 40
• Employee Type Regular
• Work Shift Day (United States of America)
• Pay Range $21.00 - $28.30/Hourly
• Grade 3

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.

EEO Statement

Mass General Brigham Incorporated 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 Section503of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and TitleIof 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.

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Our history includes New England hospitals founded over 200 years ago, some of the first and most prestigious hospitals in the world. Built on the legacy of two leading academic medical centers, we’re more than a system—we’re leaders in the practice of medicine. Mass General Brigham is committed to serving the community. We are dedicated to enhancing patient care, teaching and research, and taking a leadership role as an integrated health care system. We recognize that increasing value and continuously improving quality are essential to maintaining excellence.