Insurance Authorization Specialist

Job Description

Job Description

Veterans Inc. is seeking an Insurance Authorization Specialist who will be responsible for managing insurance eligibility and authorizations from admission through discharge. The Specialist will work closely with Admissions, Clinical/Case Management, and Billing to ensure that patients have the appropriate insurance coverage and authorizations.

This position is based at 69 Grove Street, Worcester, MA, and requires a flexible schedule including evenings and weekends as needed.

WHAT YOU'LL BE RESPONSIBLE FOR DAY TO DAY:

• Obtain and manage initial insurance authorizations (Notice of Admission) for all new admissions.
• Communicate with insurance companies, utilization review departments, and payer portals to manage the delivery of sensitive information with respect to expiration dates and changes in patient status.
• Obtain required clinical information from Clinical/Case Management for continued-stay requests.
• Maintain accurate authorization numbers, dates, units/days, and payer information in EHR.
• Work closely with Admissions and Billing to process authorization requirements and insurance claims.

WHAT YOU MUST HAVE:

• Strong organizational and communication skills, with the ability to manage multiple payer requirements and deadlines.
• Experience with Behavioral health, substance-use-disorder, CSS, RRS, BSAS, MassHealth, or Massachusetts payer.
• Proven experience processing insurance authorizations, healthcare revenue cycle, utilization management, or related healthcare operations.
• Knowledge of MassHealth eligibility, managed care organizations, and enrollment processes preferred.
• Certified Application Counselor (CAC) certification preferred; candidates without current certification must complete required training and certification within six months of employment.
• Must be able to successfully pass a CORI/Background records check.
• Compliance with Veterans Inc. COVID-19 Vaccination Policy. Religious and Medical Exemptions are considered.

WHAT WE CAN OFFER YOU:

Comprehensive Benefits Package for FT employees includes:

• BCBS Medical, Dental, and Vision Insurance
• Employer Paid Short and Long-Term Disability and Life Insurance.
• $2,500 Medical Opt-Out program if you have medical coverage through another source.
• Retirement Plan (403B) with a $3,000 Match
• Flexible Spending Accounts
• Tuition Reimbursement Program
• Paid Parental Leave

For more information, or to apply now, visit our website. Please do not mail, email, or fax your cover letter/resume as we are limited to only accepting completed applications through our career page. Mailed, emailed, or faxed cover letter, resume, and applications will not be reviewed.

Veterans Inc. is proud to be an equal opportunity employer. We are committed to equal employment opportunity regardless of race, color, religion, sex, national origin, sexual orientation, age, marital status, disability, gender identity or protected Veteran status. If you need assistance completing an application, please contact View email address on click.appcast.io .

We do not accept unsolicited resumes from agencies. Agencies are requested not to contact Veterans Inc. with recruiting inquiries.