Insurance Authorization Specialist: Access & Revenue Impact

Veterans Inc.; Worcester (MA); On-site; USD 60,000 - 73,000; Full time

Benefits offered by this job

BCBS Medical, Dental, and Vision

Disability & Life Insurance

Medical Opt-Out $2500

403B Match

Flexible Spending Accounts

Tuition Reimbursement

Paid Parental Leave

Job summary

Veterans Inc. in Worcester, MA is seeking an Insurance Authorization Specialist to manage eligibility and authorizations from admission through discharge.

You will verify eligibility, obtain initial authorizations, track ongoing authorizations, handle payer follow-up, and assist MassHealth enrollment to ensure timely admissions and payments. This role collaborates with Admissions, Clinical/Case Management, and Billing to maintain accurate insurance data in the EHR, resolve coverage issues, and

Qualifications

• Experience with insurance authorizations and healthcare revenue cycle.
• Knowledge of MassHealth enrollment processes preferred.
• Strong organizational, communication, and follow-up skills.

Responsibilities

• Obtain and manage initial insurance authorizations (Notice Of Admission).
• Monitor authorization expiration dates and obtain continued-stay extensions.
• Process authorization requirements when a patient’s insurance changes.
• Communicate with insurance companies, utilization review departments, and payer portals.
• Obtain clinical information for continued-stay requests.
• Maintain accurate authorization data in the EHR.
• Monitor authorization worklists and resolve exceptions.
• Identify and elevate denials or coverage issues.
• Collaborate with Admissions and Billing to ensure required authorizations.

Skills

Organizational skills

Communication skills

Follow-up skills

Multitasking

Education

CAC certification (preferred)

Tools

AdvancedMD

Job description

Veterans Inc. in Worcester, MA is seeking an Insurance Authorization Specialist to manage eligibility and authorizations from admission through discharge.

You will verify eligibility, obtain initial authorizations, track ongoing authorizations, handle payer follow-up, and assist MassHealth enrollment to ensure timely admissions and payments. This role collaborates with Admissions, Clinical/Case Management, and Billing to maintain accurate insurance data in the EHR, resolve coverage issues, and