Top 42 Prior authorization specialist Jobs in Quincy Ma

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
4d
Authorization Specialist
New England Life Care —Canton, MA
- $21 - $22 an hour
- Full-time
- Microsoft Word
- Microsoft Excel
- Customer service
- Disability insurance
- Health insurance
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Financial Clearance Specialist
South Shore Health —Norwell, MA
- $22.20 - $31.75 an hour
- Full-time
- Hospital
- Customer service
- Computer literacy
10d
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
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
Scheduling Specialist
RAYUS Radiology —Dedham, MA
- $18.58 - $26.90 an hour
- Temporary
- Bilingual
- Computer literacy
- High school diploma or GED
- Paid holidays
- Disability insurance
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Referral Specialist, Neurology
Beth Israel Lahey Health —Boston, MA
- $23.15 - $34.40 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Hospital
Patient and Insurance Coordinator
Vascular Care Specialists —Brockton, MA
- Full-time
- HIPAA
- Mid-level
- High school diploma or GED
- AD&D insurance
- Paid holidays
Quick Apply
5d
Intake Specialist - Full Time
CATALDO AMBULANCE SERVICE —Somerville, MA
- $20 - $26 an hour
- Full-time
- Background check
- 18 years or older
- Writing skills
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Hybrid Remote-In Office Insurance Verification and Billing Specialist
OTA Kids Pediatric Therapy —Wakefield, MA
- $22 - $26 an hour
- Part-time
- Hybrid work
- 5 years
- Computer literacy
- Medical office experience
Quick Apply
Ambulatory Pharmacy Technician Specialist
Beth Israel Lahey Health —Westwood, MA
- $32.00 - $43.07 an hour
- Full-time
- English
- Clinic experience
- Mid-level
- Prescription drug insurance
Specialist, Clinical Support
NeighborHealth —Boston, MA
- $24 - $36 an hour
- Online Application
- Bilingual
- Background check
- Word processing
- Paid holidays
- Disability insurance
Medical Biller Part Time or Full Time
Eye Care Specialists —Norwood, MA
- $25 - $30 an hour
- Part-time
- Private practice
- Mid-level
- Organizational skills
- Paid holidays
- Disability insurance
Quick Apply
Senior Clinical Informaticist
Cohere Health —Boston, MA
- $75,000 - $100,000 a year
- Nursing
- RN License
- Master's degree
- Paid parental leave
- Health savings account
Quick Apply
Patient Service Specialist
Brown University Health —Foxborough, MA
- $18.13 - $29.90 an hour
- 8 hour shift
- Microsoft Excel
- Microsoft Outlook
- High school diploma or GED
Clinical Practice Specialist – Transplant
Beth Israel Lahey Health —Boston, MA
- $21.00 - $28.26 an hour
- Call employer
- Hospital
- Computer literacy
- English
Medical Office Assistant-Adult Medicine
BROCKTON NEIGHBORHOOD HEALTH CENTER INC —Brockton, MA
- $17.75 - $24.00 an hour
- Per diem
- Bilingual
- Computer literacy
- High school diploma or GED
Quick Apply
Billing Specialist - Full Time
CATALDO AMBULANCE SERVICE —Somerville, MA
- $24 - $30 an hour
- Full-time
- Background check
- 18 years or older
- Microsoft Excel
Quick Apply
Medical Biller
Aspire Health and Community Services —Braintree, MA
- $26.94 an hour
- Mid-level
- Analysis skills
- 2 years
Referral specialist
BAYON MEDICAL GROUP LLC —Lynn, MA
- $22 - $24 an hour
- Part-time
- Medical office experience
- English
- Administrative experience
Quick Apply

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Prior Authorization Specialist

Mass General Brigham Incorporated -
Somerville, MA

Quick Apply

Job Details

Full-time
$28.30 an hour
4 days 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

prior authorization specialist jobs in quincy ma

Prior Authorization Specialist

Authorization Specialist

Financial Clearance Specialist

Specialty Medication Access Coordinator

Sr Prior Authorization Specialist – Winchester Hospital

Scheduling Specialist

Referral Specialist, Neurology

Patient and Insurance Coordinator

Intake Specialist - Full Time

Hybrid Remote-In Office Insurance Verification and Billing Specialist

Ambulatory Pharmacy Technician Specialist

Specialist, Clinical Support

Medical Biller Part Time or Full Time

Senior Clinical Informaticist

Patient Service Specialist

Clinical Practice Specialist – Transplant

Medical Office Assistant-Adult Medicine

Billing Specialist - Full Time

Medical Biller

Referral specialist

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