Top 103 Referral specialist Jobs in Massachusetts

Prior Authorization Specialist
Mass General Brigham Incorporated —Somerville, MA
- $28.30 an hour
- Full-time
- Remote
- HIPAA
- High school diploma or GED
- Organizational skills
- Opportunities for advancement
Quick Apply
1d
Financial Clearance Specialist- REMOTE
UMass Memorial Health —Worcester, MA
- $17.43 - $31.37 an hour
- 8 hour shift
- Remote
- Customer service
- Medical office experience
- High school diploma or GED
Referral Specialist, Neurology
Beth Israel Lahey Health —Boston, MA
- $23.15 - $34.40 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Hospital
INFORMATION AND REFERRAL SPECIALIST
Health & Social Services Consortium —Sharon, MA
- Full-time
- Entry level
- Mileage reimbursement
- Disability insurance
Team Lead, Prior Authorizations
Mass General Brigham Incorporated —Somerville, MA
- $25.50 - $36.49 an hour
- Full-time
- Remote
- HIPAA
- 3 years
- High school diploma or GED
- Opportunities for advancement
Quick Apply
1d
Sr Prior Authorization Specialist – Winchester Hospital
Beth Israel Lahey Health —Winchester, MA
- $21.53 - $28.98 an hour
- Full-time
- Hybrid work
- Hospital
- English
- Research
Administrative & Referral Coordinator (Ortho Forms & FMLA Coord.)
Boston Medical Center —Boston, MA
- $21.39 - $30.05 an hour
- Full-time
- Surgery
- Medical office experience
- English
- Health insurance
- Dental insurance
Imaging Resource Specialist I
Optum —Weymouth, MA
- $16 - $29 an hour
- Full-time
- Hybrid work
- Medical office experience
- Pass drug screening
- Research
- AD&D insurance
- Employee stock purchase plan
Financial Coordinator -BIDMC (Heart Transplant Program)
Beth Israel Lahey Health —Boston, MA
- $30.45 - $40.98 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Hospital
Referral Specialist
Optum —Acton, MA
- $16 - $29 an hour
- Full-time
- Word processing
- Pass drug screening
- HIPAA
Quick Apply
Administrative & Referral Coordinator - Orthopedic Surgery
Boston Medical Center —Boston, MA
- $21.39 - $30.05 an hour
- Full-time
- Microsoft Outlook
- Surgery
- English
- Health insurance
- Dental insurance
Insurance Authorization Representative
Sturdy Health —Attleboro, MA
- $19.85 - $30.05 an hour
- Full-time
- Surgery
- Computer literacy
- HIPAA
- Health insurance
- Dental insurance
Referrals Specialist - (16.5-hours)
Greater Lawrence Family Health Center —Methuen, MA
- 8 hour shift
- Hybrid work
- Spanish
- Internal Medicine
- English
- Tuition reimbursement
Quick Apply
Administrative & Referral Coordinator
Boston Medical Center —Boston, MA
- $21.39 - $30.05 an hour
- Full-time
- English
- Mid-level
- Windows
- Health insurance
- Dental insurance
8d
Specialty Medication Access Coordinator
Beth Israel Lahey Health —Burlington, MA
- $33.60 - $45.22 an hour
- Full-time
- 5 years
- English
- High school diploma or GED
Surgical Scheduler and Surgery Authorization
New England ENT & Facial Plastic Surgery —North Andover, MA
- Full-time
- Surgery
- Mid-level
Quick Apply
Insurance Specialist
RAYUS Radiology —Chelmsford, MA
- Temporary
- Bilingual
- Computer literacy
- HIPAA
- Paid holidays
- Disability insurance
Quick Apply
Financial Clearance Specialist
Cornerstone Community Care —Massachusetts
- $20 - $30 an hour
- Part-time
- Remote
- Customer service
- Medical office experience
- HIPAA
- Flexible schedule
Quick Apply
1d
Authorization Specialist
Option Care Health —Boston, MA
- $19.57 - $32.63 an hour
- Full-time
- High school diploma or GED
- Travel
- Leadership
- Health savings account
- Health insurance
6d
Patient Support Specialist, Patient Solutions & Support Programs
EMD-Merck US —Boston, MA
- $33 - $50 an hour
- Full-time
- Spanish
- HIPAA
- English
- Health insurance
- Paid time off
Quick Apply
8d

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Prior Authorization Specialist

Mass General Brigham Incorporated -
Somerville, MA

Quick Apply

Job Details

Full-time
$28.30 an hour
1 day ago

Benefits

Opportunities for advancement

Qualifications

Customer inquiry handling
High school diploma or GED
Video conferences (communication methods)
Video conferencing systems operation

Full Job Description

Site: Mass General Brigham Incorporated

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

Summary

Reviews and processes prior authorization and referral requests for medical services in accordance with organizational policies and payer requirements. Ensures insurance eligibility, coordination of benefits, site‑of‑care compliance, and medical necessity by gathering and submitting complete medical documentation in alignment with HIPAA standards. Accurately documents authorization outcomes and all payer communications in the electronic health record.

Essential Functions

Work as part of a group to secure insurance authorizations in an appropriate timeframe. Collects and accurately enters information required by third parties for precertification for procedures, tests and imaging.

When unclear, collaborates with ordering clinicians to ensure the proper CPT codes are submitted for prior authorization or referrals.

Refer patients to financial counseling, as appropriate.

Inform patient of authorization concerns prior to admission/procedure, coordinating with appropriate parties to facilitate authorization as appropriate, collaborating with other departments/offices to resolve complex authorization issues.

Update authorization status in system and complete workflow.

Respond to internal and external inquiries regarding authorization decisions and provide explanations as needed.

Qualifications

Education

High School Diploma or Equivalent required

Experience

Medical authorization or related field experience 1-2 years preferred
Epic experience 0-1 year preferred

Knowledge, Skills and Abilities

- Excellent attention to detail and organizational skills.
- Strong communication and interpersonal skills.
- Knowledge of medical terminology and medical insurance benefits, including a complete understanding of the coordination of benefits.
- Familiarity with computer systems and databases.
- Ability to work independently and as part of a team.
- Ability to work in a fast-paced environment.

Additional Job Details (if applicable)

Remote Model Requirements

Remote
M-F Eastern business hours required
Employees must use a stable, secure, and compliant workstation in a quiet environment. Teams video is required and must be accessed using MGB-provided equipment.

Remote Type

Remote

Work Location

399 Revolution Drive

Scheduled Weekly Hours

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$ - $28.30/Hourly

Grade

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

EEO Statement:

0100 Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

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Refine Your Search

referral specialist jobs in massachusetts

Prior Authorization Specialist

Financial Clearance Specialist- REMOTE

Referral Specialist, Neurology

INFORMATION AND REFERRAL SPECIALIST

Team Lead, Prior Authorizations

Sr Prior Authorization Specialist – Winchester Hospital

Administrative & Referral Coordinator (Ortho Forms & FMLA Coord.)

Imaging Resource Specialist I

Financial Coordinator -BIDMC (Heart Transplant Program)

Referral Specialist

Administrative & Referral Coordinator - Orthopedic Surgery

Insurance Authorization Representative

Referrals Specialist - (16.5-hours)

Administrative & Referral Coordinator

Specialty Medication Access Coordinator

Surgical Scheduler and Surgery Authorization

Insurance Specialist

Financial Clearance Specialist

Authorization Specialist

Patient Support Specialist, Patient Solutions & Support Programs

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