Managed Care Assistant

Site: Mass General Brigham Incorporated

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.

Job Summary

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.

Essential Functions

• 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.
  
  

Qualifications

Education

• High School Diploma or equivalent required
• Associate's Degree Health Administration preferred
  
  

Experience

• 1 years of experience working in a hospital or healthcare setting preferred
  
  

Knowledge, Skills And Abilities

• 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.
  
  

Additional Job Details (if Applicable)

Remote Type

Remote

Work Location

399 Revolution Drive

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$19.81 - $28.30/Hourly

Grade

3

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

0100 Mass General Brigham Incorporated 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.