Massgeneralbrigham

Compensation

Full Description

Site: The General Hospital Corporation 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. Are you passionate about healthcare operations and patient advocacy? Join our Radiation Oncology team as an Insurance Specialist, where your expertise will directly impact patient care and treatment access. In this role, you'll be an integral part of the authorization process for radiation procedures, working closely with nurses, physicians, and clinical staff to ensure timely and accurate insurance approvals. Job Summary Under the general supervision of the Administrative Manager and according to the established policies and procedures, the Insurance specialist is responsible for overseeing the Radiation Oncology authorization process. Working very closely with nurses, physicians and other clinical staff members to ensure a quality-based, customer-oriented flow of work throughout the practice. Handles all aspects of insurance issues and assists patients with all the financial aspects of their visit. Serves as the subject matter expert in radiation oncology authorizations, and is the resource person for support staff, intake manager and all clinical staff. Key Responsibilities Serve as the department's subject matter expert on insurance authorizations for radiation treatments (e.g., Proton, IMRT, VMAT, SRS, SBRT, 3D). Determine patient eligibility and secure prior authorizations and pre-determinations from third-party payers. Collaborate with physicians to coordinate peer-to-peer reviews and draft letters of medical necessity. Proactively inform patients and providers of coverage issues before appointments are scheduled. Manage denied claims, guide staff on appeals, and work to overturn denials successfully. Maintain accurate records of referrals, authorizations, and billing transactions using Epic and other systems. Attend weekly Proton rounds and managed care meetings to communicate insurance updates and treatment availability. Optimize patient scheduling and treatment slot utilization using departmental tools. Support billing and charge review processes, including generating cost estimates for international patients. Qualifications EDUCATION: High School Diploma or GED required. Associates Degree or higher preferred EXPERIENCE: -Minimum of 5 years of healthcare experience -Knowledge of third party payers Knowledge of ICD10 and CPT coding a plus -Must have basic knowledge of Anatomy and Physiology Medical terminology and medical coding knowledge desired. -Willingness to continually learn and grow as a member of a Team and Department SKILLS/ ABILITIES/ COMPETENCIES REQUIRED: -Basic knowledge of Outlook, word and excel. Will train in department database system. -Ability of work independently and prioritize work. -Excellent customer service and communication skills -Good organizational skills required to handle multiple tasks in a busy environment The right candidate must have a positive attitude, quick mind, and thrive with working under strict timelines. Additional Job Details (if applicable) Remote Type Remote Work Location 100 Blossom Street Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $18.99 - $27.17/Hourly Grade 4 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: The General Hospital Corporation 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.