Managed Care Assistant

Mass General Brigham•Somerville, MA

4d•Remote

About The Position

Responsible for providing administrative support to Home Care. This position primarily focuses on insurance verification, authorizations, and reimbursement processes to ensure timely and accurate payments for healthcare services.

Requirements

High School Diploma or equivalent required
1+ years of experience working in a hospital or healthcare setting preferred
Knowledge of insurance verification, authorizations, and reimbursement processes.
Familiarity with medical terminology and coding systems (e.g., CPT, ICD-10) is desirable.
Proficient in using computer software applications, including electronic health record systems and insurance verification platforms.
Excellent organizational skills with attention to detail and accuracy.
Strong interpersonal and communication skills to effectively interact with patients, insurance providers, and healthcare professionals.
Ability to work independently and collaboratively in a fast-paced environment.

Nice To Haves

Associate's Degree Health Administration preferred

Responsibilities

Verify insurance coverage and eligibility for patients prior to scheduled procedures or admissions.
Obtain and document necessary authorizations for services, including pre-certification, prior authorization and re-authorization from insurance companies.
Assist patients in understanding their insurance benefits and coverage limitations.
Liaise with healthcare providers, insurance companies, and patients to resolve any insurance-related issues or denials.
Maintain accurate and up-to-date records of insurance verifications, authorizations, and reimbursement documentation.
Collaborate with the billing department to ensure proper coding and billing practices for reimbursement.
Assist patients in understanding their financial responsibilities, including co-pays, deductibles, and out-of-pocket expenses.