Prior Authorization Specialist, Neurology

Site: The Brigham and Womens Hospital Inc.

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

Department of Neurology Hybrid Schedule Monday - Friday

Help patients access the care they need while building your career in healthcare!
We are seeking a detail-oriented organized and motivated Prior Authorization Specialist II to join our Department of this important role youll help patients navigate insurance requirements coordinate authorizations and referrals and resolve barriers that may delay access to care.

Working alongside providers clinical teams and revenue cycle professionals youll play a key role in ensuring timely authorizations accurate documentation and efficient reimbursement processes while gaining valuable experience in a specialized healthcare environment.

What Youll Do

- Manage insurance authorizations referrals and eligibility verification ensuring timely processing and accurate documentation in Epic.
- Coordinate with insurance companies specialty pharmacies providers and clinical teams to obtain necessary approvals and supporting documentation.
- Independently manage complex high-cost and time-sensitive authorization requests escalating issues when appropriate.
- Monitor and resolve authorization-related denials support reconsiderations and appeals and collaborate with billing and revenue cycle teams to address reimbursement barriers.
- Communicate with patients regarding authorization status insurance requirements and next steps to help prevent delays in care.
- Review payer policies coverage guidelines and provider schedules to identify and address potential insurance or authorization issues.
- Maintain accurate records manage work queues and identify opportunities to improve workflows and reduce authorization delays.
- Serve as a resource for authorization and referral questions support training of new team members and collaborate across departments to ensure efficient operations.

Qualifications

• High school diploma or equivalent required.
• 23 years of experience in medical authorizations or a related field required.
• Previous Epic experience preferred.
• Knowledge of medical terminology insurance benefits coordination of benefits and authorization processes.
• Strong computer proficiency organizational skills and exceptional attention to detail.
• Excellent communication and interpersonal skills with the ability to navigate complex insurance-related issues.
• Ability to work independently and collaboratively while managing competing priorities in a fast-paced environment.

Additional Job Details (if applicable)

Why Join Our Team

• Hybrid work arrangement
• Comprehensive benefits including medical dental and vision coverage
• 403(b) retirement plan
• Tuition reimbursement
• Discounted MBTA pass and additional employee perks
• Role-specific career growth opportunities
• Opportunity to develop specialized expertise in prior authorizations insurance operations and revenue cycle management
• Collaborate with multidisciplinary teams dedicated to improving patient access to neurological care
• Gain valuable experience managing complex insurance processes and contributing to operational improvements

Youll play an important role in helping patients access the neurological care they need while building valuable expertise in healthcare operations. Join a team where your problem-solving skills attention to detail and commitment to exceptional patient service make a meaningful impact every day!

Remote Type

Hybrid

Work Location

1620 Tremont Street

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$22.22 - $31.71/Hourly

Grade

4

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 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:

2200 The Brigham and Womens Hospital Inc. 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 Veterans 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 .

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.

Required Experience:

IC