Financial Clearance Specialist (Remote)

About Us

Mass General Brigham Integrated Care is a system-led operating entity formed by Mass General Brigham to develop new high quality, low cost, innovative community-based ambulatory care.This work stems from Mass General Brigham’s unified system strategy to bring health care closer to patients while lowering total health care costs. MGB Integrated Care will provide a wide range of offerings, including outpatient surgery, imaging, primary care, behavioral and mental health, and specialty care, both digitally as well as at physical locations across the state and region.

We aspire to be people’s first choice for health and care

– rooted in well-being and kindness –

by bringing world-class care closer to home (or at home!) and

being the bridge to world-renowned hospitals and research when needed.

We are looking for team members who possess not only the relevant skills and growth potential, but positive attitudes, flexibility, and creative mindsets to join our expanding team. Opportunities exist for team members to contribute both in their primary domain as well as in other areas of the organization.

Our core values are shared fundamental beliefs that guide our decision-making and behavior and bind us together as a team. At MGB Integrated Care, we are:

• Bravely Human: We approach our work with empathy, vulnerability, and kindness.
• Clearly Honest: We seek to provide clarity amongst our teams and patients.
• Proudly Collaborative: We are all part of a team - each bringing our unique talents to bear.
• Intentionally Consistent: We intentionally live our purpose, providing a cohesive experience for both patients and providers.
• Exceptionally Creative: We continue to learn, grow, and iterate on the ways we work.

General Overview

Under the direction of the Financial Clearance Manager, the Financial Clearance Specialist will be responsible for obtaining and processing all necessary patient information to facilitate insurance referrals and authorizations. The Financial Clearance Specialist supports the goal of obtaining maximum insurance reimbursement while providing timely, efficient, and high-quality service to patients and referring providers.

What You’ll Work On

• Checks patient eligibility and benefits with insurance companies to ensure appropriate coverage of services.
• Obtains referrals and authorizations as needed prior to service.
• Ensures accuracy of all information conveyed in authorization request and addresses errors in a timely fashion.
• Communicates with providers and scheduling staff when encountering denials or missing clinical information required to process authorization.
• Assists with estimates for patients that are self-pay or have a non-contracted plan.
• Reviews medical policies of payers to ensure patient qualifies for procedure.
• Delivers exemplary customer service for patients in accordance with Mass General Brigham expectations / guidelines.
• Monitors upcoming appointments and financially clears patients in a timely manner.
• Works collaboratively with team to help improve workflows and remains flexible to change assignments depending on volume.
• Performs other related duties as assigned.

Qualifications

• Experience
  • 2-3 years in hospital registration/billing office/clinic with a current working knowledge of registration, insurance, and billing requirements.
  • Epic experience preferred.
• Education
  • Associate's degree preferred. High School Diploma or equivalent required.

Mass General Brigham 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.