Insurance Authorization Specialist - MassHealth & Payer

Veterans Inc; Worcester (MA); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

BCBS Medical

Dental Insurance

Vision Insurance

Disability Insurance

Life Insurance

Medical Opt-Out

403B Match

Flexible Spending Accounts

Tuition Reimbursement

Parental Leave

Job summary

Veterans Inc. in Worcester, MA is seeking an Insurance Authorization Specialist to manage initial authorizations through discharge, verify eligibility, and handle continued-stay extensions.

You will collaborate with Admissions, Clinical/Case Management, and Billing to keep EHR insurance data accurate and prevent delays in admissions or payments. The role operates on an exception-management model, tracking authorizations, changes, and denials, while assisting MassHealth enrollment and payer

Qualifications

• Experience with insurance authorizations and healthcare revenue cycle operations.
• Knowledge of MassHealth eligibility and enrollment processes preferred.
• AdvancedMD experience preferred; CAC certification considered.

Responsibilities

• Obtain and manage initial insurance authorizations for all new admissions.
• Monitor authorization expiration dates and obtain continued-stay extensions.
• Process authorization updates when a patient’s insurance changes.
• Communicate with insurance companies, utilization review departments, and payer portals.
• Maintain accurate authorization numbers, dates, units/days, and payer information in EHR.
• Identify and elevate authorization denials, reductions, or coverage issues.

Skills

Insurance authorizations

Revenue cycle

Utilization management

MassHealth enrollment

Tools

AdvancedMD

Job description

Veterans Inc. in Worcester, MA is seeking an Insurance Authorization Specialist to manage initial authorizations through discharge, verify eligibility, and handle continued-stay extensions.

You will collaborate with Admissions, Clinical/Case Management, and Billing to keep EHR insurance data accurate and prevent delays in admissions or payments. The role operates on an exception-management model, tracking authorizations, changes, and denials, while assisting MassHealth enrollment and payer