Insurance/Authorization Review

Mass General Brigham•Newton, MA

4d•$21 - $25•Onsite

About The Position

The Insurance/Authorization Review role at Newton-Wellesley Hospital helps patients navigate insurance authorization while supporting timely, accurate reimbursement for medical services. The position works with patients, healthcare providers, and insurance companies to obtain and review authorizations, clarify coverage, and resolve authorization issues. It does not involve direct patient care. The role is onsite at 159 Wells Avenue in Newton, Massachusetts, with a scheduled day shift from 8:00 a.m. to 4:30 p.m. and 40 scheduled hours per week.

Requirements

High school diploma or equivalent required.
Two to three years of healthcare insurance billing experience required.
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, including the ability to explain complex insurance and billing concepts to patients and healthcare providers.
Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.
Experience cannot substitute for the required education.

Nice To Haves

Associate’s degree in Healthcare Management or a related field preferred.

Responsibilities

Verify insurance coverage for services, procedures, and treatments.
Collect and update patient insurance information, including policy numbers, effective dates, and authorization details.
Contact insurance companies to obtain or clarify authorizations, including pre-approvals and pre-certifications.
Partner with billing and coding staff to support accurate, timely claim submissions.
Coordinate prior authorizations for procedures, tests, surgeries, and other services requiring approval.
Review authorization-related insurance denials, gather supporting documentation, and collaborate with healthcare providers on appeals and resubmission of authorization requests as needed.
Help patients understand their insurance coverage, benefits, and authorization requirements.