Insurance Coordinator

Massachusetts General Hospital
United States, Massachusetts, Boston
1620 Tremont Street (Show on map)
Mar 06, 2025
Summary Responsible for managing the insurance authorization process by working closely with patients, healthcare providers, and insurance companies to obtain and review insurance authorizations for medical services, ensuring accurate and timely reimbursement. Essential Functions Verify insurance coverage for specific services, procedures, or treatments, ensuring that the services provided are covered by the patient's insurance plan. -Collect and update patient insurance information, including policy numbers, effective dates, and authorization details. -Collaborate with insurance companies to obtain or clarify insurance authorizations, including pre-approvals and pre-certifications. -Collaborate with billing and coding staff to ensure that claims are submitted accurately and in a timely manner. -Facilitate the prior authorization process for procedures, tests, surgeries, and other services requiring pre-authorization. -Review insurance denials related to authorization issues, gather supporting documentation, and collaborate with healthcare providers to develop appeals and resubmit authorization requests as necessary. -Assist patients in understanding their insurance coverage, benefits, and authorization requirements. Education High School Diploma or Equivalent required or associate's degree Healthcare Management preferred, or associate's degree Related Field of Study preferred Experience Healthcare Insurance Billing Experience 2-3 years required Knowledge, Skills and Abilities - Strong knowledge of insurance verification, claims processing, and reimbursement practices. - Understanding of insurance coverage, benefit structures, and claim submission requirements. - Excellent attention to detail and accuracy in data entry, documentation, and claim submissions. - Effective communication and interpersonal skills, with the ability to communicate complex insurance and billing concepts to patients and healthcare providers. - Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment. Physical Requirements Standing Occasionally (3-33%) Walking Occasionally (3-33%) Sitting Constantly (67-100%) Lifting Occasionally (3-33%) 20lbs - 35lbs Carrying Occasionally (3-33%) 20lbs - 35lbs Pushing Rarely (Less than 2%) Pulling Rarely (Less than 2%) Climbing Rarely (Less than 2%) Balancing Occasionally (3-33%) Stooping Occasionally (3-33%) Kneeling Rarely (Less than 2%) Crouching Rarely (Less than 2%) Crawling Rarely (Less than 2%) Reaching Occasionally (3-33%) Gross Manipulation (Handling) Constantly (67-100%) Fine Manipulation (Fingering) Frequently (34-66%) Feeling Constantly (67-100%) Foot Use Rarely (Less than 2%) Vision - Far Constantly (67-100%) Vision - Near Constantly (67-100%) Talking Constantly (67-100%) Hearing Constantly (67-100%) The General Hospital Corporation is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. 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.