Insurance Verification Specialist
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
Responsible for verifying patient insurance coverage and benefits, confirming pre-authorizations, and obtaining necessary authorizations for medical services in order to support the revenue cycle by ensuring that insurance information is accurate, billing is appropriate, and claims processing proceeds smoothly.
Essential Functions
-Obtain and verify patient insurance information, including policy details, coverage limits, and effective dates.
-Contact insurance companies or third-party payers to confirm eligibility, benefits, and co-payment or deductible amounts.
-Coordinate with healthcare providers and insurance companies to obtain pre-authorizations or prior authorizations for medical services, surgeries, or procedures.
-Explain insurance benefits and coverage details to patients, ensuring they understand their financial responsibilities and co-payment requirements.
-Enter accurate insurance information into the hospital's billing system and maintain updated records of insurance verification and authorization status.
-Assist the billing team in resolving insurance-related issues that may arise during the claims processing process.
-Communicate with patients to inform them of their insurance verification status and any potential financial obligations.
Qualifications
Education
High School Diploma or Equivalent required
Associate's Degree Healthcare Management or related field of study preferred
Experience
2+ years of healthcare billing experience preferred
Knowledge, Skills and Abilities
Knowledgeable of medical billing codes, insurance claim processing, and payment posting procedures.
Knowledge of healthcare billing regulations, HIPAA, and compliance requirements.
Strong attention to detail and data accuracy to ensure precise payment posting and reconciliation.
Excellent communication and customer service skills to interact with insurance companies, patients, and internal stakeholders.
Demonstrated problem-solving and critical-thinking skills to resolve payment discrepancies and denials effectively.
Additional Job Details (if applicable)
Remote Type
Remote
Work Location
399 Revolution Drive
Scheduled Weekly Hours
0
Employee Type
Per Diem
Work Shift
Evening (United States of America)
Pay Range
$25.50 - $36.49/Hourly
Grade
5
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.
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
Responsible for verifying patient insurance coverage and benefits, confirming pre-authorizations, and obtaining necessary authorizations for medical services in order to support the revenue cycle by ensuring that insurance information is accurate, billing is appropriate, and claims processing proceeds smoothly.
Essential Functions
-Obtain and verify patient insurance information, including policy details, coverage limits, and effective dates.
-Contact insurance companies or third-party payers to confirm eligibility, benefits, and co-payment or deductible amounts.
-Coordinate with healthcare providers and insurance companies to obtain pre-authorizations or prior authorizations for medical services, surgeries, or procedures.
-Explain insurance benefits and coverage details to patients, ensuring they understand their financial responsibilities and co-payment requirements.
-Enter accurate insurance information into the hospital's billing system and maintain updated records of insurance verification and authorization status.
-Assist the billing team in resolving insurance-related issues that may arise during the claims processing process.
-Communicate with patients to inform them of their insurance verification status and any potential financial obligations.
Qualifications
Education
High School Diploma or Equivalent required
Associate's Degree Healthcare Management or related field of study preferred
Experience
2+ years of healthcare billing experience preferred
Knowledge, Skills and Abilities
Knowledgeable of medical billing codes, insurance claim processing, and payment posting procedures.
Knowledge of healthcare billing regulations, HIPAA, and compliance requirements.
Strong attention to detail and data accuracy to ensure precise payment posting and reconciliation.
Excellent communication and customer service skills to interact with insurance companies, patients, and internal stakeholders.
Demonstrated problem-solving and critical-thinking skills to resolve payment discrepancies and denials effectively.
Additional Job Details (if applicable)
Remote Type
Remote
Work Location
399 Revolution Drive
Scheduled Weekly Hours
0
Employee Type
Per Diem
Work Shift
Evening (United States of America)
Pay Range
$25.50 - $36.49/Hourly
Grade
5
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.