Remote Prior Authorization Specialist - Part Time

Mass General Brigham; Somerville (MA); Remote; USD 31.000 - 44.000; Teilzeit

Benefits dieser Stelle

Fully remote

Part-time

Zusammenfassung

Mass General Brigham is seeking a remote, part-time Prior Authorization Specialist to perform advanced authorization and referral activities. You will verify insurance eligibility, coordinate benefits, and ensure medical necessity by gathering documentation in line with HIPAA standards.

This role involves high-dollar, time-sensitive cases, collaboration with clinicians, and accurate payer communication in the electronic health record.

Qualifikationen

• High School Diploma or equivalent required.
• 2–3 years experience in medical authorization or related field.
• Epic experience preferred.
• Excellent attention to detail and organizational skills.

Aufgaben

• Process advanced prior authorizations and referrals in a timely manner.
• Gather and submit complete medical documentation to support authorization and medical necessity.
• Collaborate with ordering clinicians to ensure proper CPT codes are used.
• Escalate complex issues to leadership and provide peer training as needed.
• Document outcomes and payer communications in the EHR.

Kenntnisse

Attention to detail

Communication skills

Medical terminology knowledge

Insurance benefits knowledge

Independent work

Team collaboration

Fast-paced environment

Ausbildung

High School Diploma or equivalent

Tools

Epic

Jobbeschreibung

Mass General Brigham is seeking a remote, part-time Prior Authorization Specialist to perform advanced authorization and referral activities. You will verify insurance eligibility, coordinate benefits, and ensure medical necessity by gathering documentation in line with HIPAA standards.

This role involves high-dollar, time-sensitive cases, collaboration with clinicians, and accurate payer communication in the electronic health record.