Insurance Coordinator
 Massachusetts General Hospital | |
 United States, Massachusetts, Boston | |
| 100 Blossom Street (Show on map) | |
 Sep 10, 2025 | |
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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. 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. The General Hospital Corporation 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. | |