Senior Prior Authorization Specialist - Hybrid

Beth Israel Lahey Health; Winchester (VA); Hybrid; USD 30,000 - 40,000; Full time

Job summary

Beth Israel Lahey Health, Inc. seeks a Sr. Prior Authorization Specialist to join Winchester Hospital in a hybrid role.

You will analyze information for financial reimbursement, submit to insurers for pre-approval, and coordinate with payors and patients to ensure clarity on coverage and required steps prior to service. The role requires strong insurance knowledge, 2+ years in healthcare or business settings, and excellent English communication.

Qualifications

• Two years of experience in a business/health care setting.
• Knowledge of insurance coverage and/or reimbursement is required.
• Ability to read, write and communicate effectively in English with patients and team members.

Responsibilities

• Accesses work queues and reviews patient accounts to determine financial clearance status.
• Verifies guarantor information and assigns coverages to visits.
• Identifies non-covered services and prepares ABN or waivers.
• Submits precertification requests and follows up on approvals.
• Communicates with patients about financial clearance status and steps to meet obligations.
• Escalates complex accounts to appropriate leadership for timely approval.

Skills

Insurance knowledge

Customer service

English communication

Attention to detail

Education

High School diploma

Job description

Beth Israel Lahey Health, Inc. seeks a Sr. Prior Authorization Specialist to join Winchester Hospital in a hybrid role.

You will analyze information for financial reimbursement, submit to insurers for pre-approval, and coordinate with payors and patients to ensure clarity on coverage and required steps prior to service. The role requires strong insurance knowledge, 2+ years in healthcare or business settings, and excellent English communication.