Prior Authorization Specialist

Center for Integration Science

Somerville, MA, United States
Base: $19.81 - $28.30phly; bonus/equity: not speci...
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2+ years hospital setting experience
Epic clinical system proficiency
Insurance verification and authorization
** The Center for Integration Science is seeking a Prior Authorization Specialist to facilitate patient authorizations for medical and surgical admissions within a hybrid work environment. The role requires expertise in insurance authorization processes and excellent interpersonal skills to enhance patient experiences. **

Job Summary

  • This role is critical to the organization's financial health, managing approximately $4 Billion in revenue per fiscal year.
  • The specialist acts as a liaison between physicians, insurance companies, and Patient Financial Services across multiple campuses to secure authorizations.
  • Candidates must maintain expert-level knowledge of industry standards and regulatory requirements to facilitate exceptional patient experiences.

Matching Summary

Match Score: 75

** The Center for Integration Science is seeking a Prior Authorization Specialist to facilitate patient authorizations for medical and surgical admissions within a hybrid work environment. The role requires expertise in insurance authorization processes and excellent interpersonal skills to enhance patient experiences. **

Salary

Base: $19.81 - $28.30/Hourly; Bonus/Equity: Not specified; Benefits: Comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses

Skills & Requirements

Must-have

  • 2+ years hospital setting experience
  • EPIC Clinical System proficiency
  • Insurance verification and authorization
  • CPT and Diagnosis code knowledge
  • Revenue cycle management skills

Nice-to-have

  • Strong communication with physicians
  • Ability to work in fast-paced environment
  • Subject matter expertise in pay models
  • Tactful conflict resolution skills
  • Continuous learning mindset

Key Requirements

  • Bachelor's degree preferred or high school diploma required
  • 2+ years experience in hospital settings or medical payer
  • Knowledge of insurance managed care authorization requirements

Work Rights

Not specified

Tailored Resume

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