Senior Financial Insurance Authorization Specialist

Senior Financial Insurance Authorization Specialist Location Boston, MA (Mission Hill area) :

At Boston Children's Hospital, the quality of our care - and our inclusive hospital working environment - lies in the diversity of our people. With patients from local communities and 160 countries around the world, we're committed to reflecting the spectrum of their cultures, while opening doors of opportunity for our team. Here, different talents pursue common goals. Voices are heard and ideas are shared. Join us, and discover how your unique contributions can change lives. Yours included. The Authorization Specialist is the Perfect job for new graduates or for those who want to explore a rewarding job in pediatric health care. Leadership is willing to develop and train the right candidate. Come join a dynamic team of clinicians and administrators who help BCH provide the best pediatric care in the country. We support patients, physicians and the hospital revenue cycle by financially clearing all services patients may receive; candidates may be assigned to assist all areas within the financial clearance function as our services evolve and grow over time.

Senior Financial Insurance Authorization Specialist is responsible to:

• Obtain all insurance and authorizations and managed care referrals needed for BCH patients in accordance with insurance companies' medical and administrative policies
• Manage daily caseloads to ensure timely completion of financial clearance in accordance with departmental processes & payer guidelines
• Communicate authorization statuses with key stakeholders (physicians, nurses, management, patients/families) throughout the authorization process
• Support physicians and other clinicians in any payer denial processes, in order to help obtain the proper financial clearance for access to care
• Facilitate insurance peer to peer reviews when needed to secure authorizations
• Participate in process improvement activities
• Collect, verify, and record all demographic information required for patient financial clearance in accordance with hospital policy
• Assign or move candidates to other financial clearance areas as needed or the situation requires

To qualify you must have:

• A Bachelor's or an Associate's degree preferred. The completion of High School Diploma and a min of 1 year direct experience working with health insurance, referrals and authorizations is required.
• Understanding of Microsoft Office and experience with Epic registration system a plus
• The ability to communicate effectively both orally and in writing
• The ability to resolve complex problems requiring the use of critical thinking skills and scientific, mathematical, or technical principles
• The ability to work as part of a team with diverse internal and external constituencies
• Effective organizational skills and the ability to work in a fast-paced environment to ensure completion of assignments within established time frames.
• Attention to detail and completion of tasks with accuracy
• The ability to work remotely from a home office with a strong internet connection. (Due to HIPAA and patient information, this position requires to work from a private location)

Boston Children's Hospital offers competitive compensation and unmatched benefits including flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.

Please note: During a public health emergency, individuals in this role may be expected to take on additional duties to respond to organizational needs.

Boston Children's Hospital requires all employees to be vaccinated against COVID-19 and Flu, (unless you are eligible for a medical or religious exemption).

Boston Children's Hospital is an Equal Opportunity / Affirmative Action Employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identity, protected veteran status or disability.