Prior Authorization & Insurance Verification Specialist

South Shore Health; Norwell (MA); On-site; USD 31,000 - 44,000; Full time

Job summary

South Shore Health in Norwell, MA, seeks a Financial Clearance Specialist to obtain precertification and prior authorization for admissions and procedures. You will verify insurance benefits and ensure proper authorization to support the hospital revenue cycle.

The role requires independent work, attention to detail, and proficiency with EPIC, Workday, and verification portals. Typical hours are 40 per week in a day shift.

Qualifications

• Minimum education: High school diploma; two years of college preferred.
• Minimum work experience: at least one year Financial Clearance experience.
• Ability to work independently in a fast-paced environment.
• Knowledge of hospital EHR systems in EPIC and payer policies.

Responsibilities

• Obtain precertification/prior authorization for admissions, procedures and outpatient services.
• Verify insurance benefits with all carriers.
• Ensure proper authorization in accordance with payer guidelines.
• Collaborate with Patient Access Supervisor/Manager to resolve issues.
• Maintain HIPAA confidentiality and accurate demographic data.
• Meet authorization accuracy targets and limit administrative denials.

Skills

Financial Clearance experience

Independent worker

Customer service

Attention to detail

Organizational skills

Revenue Cycle knowledge

Education

High school diploma

Two years of college

Tools

EPIC

Workday

Passport OneSource

Faxcom

AP I timecard

Medicare/Medicaid systems

Job description

South Shore Health in Norwell, MA, seeks a Financial Clearance Specialist to obtain precertification and prior authorization for admissions and procedures. You will verify insurance benefits and ensure proper authorization to support the hospital revenue cycle.

The role requires independent work, attention to detail, and proficiency with EPIC, Workday, and verification portals. Typical hours are 40 per week in a day shift.