Remote Precertification & Authorization Specialist

Tufts Corporate; Burlington (MA); Remote; USD 54,000 - 76,000; Full time

Job summary

Tufts Medicine is seeking an entry-level Patient Access Revenue Cycle Specialist to support billing, collections, cost estimates, and payment processing.

The role involves collecting demographic and financial information, scheduling services, handling referrals, and ensuring timely updates in the EMR. It requires strong communication skills and attention to detail in a fast-paced hospital setting.

Qualifications

• High school diploma or equivalent.
• 2+ years of related experience in a hospital, physician office, or financial services.
• Knowledge of ICD-10 and CPT coding.
• Thorough working knowledge of insurance and precertification requirements.

Responsibilities

• Contacts insurance companies and workers' compensation carriers to obtain verification of insurance, eligibility, and benefits; enters data into EMR.
• Contacts patients for updates of financial/demographic information and ensures timely updates in EMR.
• Obtains financial data from in-state and out-of-state payers; utilizes payer sites and outreach.
• Coordinates benefits when more than one carrier is involved.

Skills

ICD-10 coding

CPT coding

Medical terminology

Insurance knowledge

Proactive communication

Education

High school diploma or equivalent

Tools

EMR systems

Microsoft Word/Excel

Job description

Tufts Medicine is seeking an entry-level Patient Access Revenue Cycle Specialist to support billing, collections, cost estimates, and payment processing.

The role involves collecting demographic and financial information, scheduling services, handling referrals, and ensuring timely updates in the EMR. It requires strong communication skills and attention to detail in a fast-paced hospital setting.