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Boston Children's HospitalPosted 1 week ago

Authorization Specialist Associate -Remote

HybridCincinnati, Ohio, United States

Full TimeEntry LevelAssociates DegreeLargeHealthcare

Job Summary

Collect necessary insurance benefit and clinical information to authorize services or provide accurate cost estimates based on patient coverage. Apply patient benefits and coverage information through IT applications to determine service costs and clarify patient financial responsibilities. Communicate appropriate clinical information to insurance companies to ensure services are rendered at the correct level of care and meet authorization requirements. Maintain expert knowledge of insurance plans, regulations, and coverage structures while serving as a point of contact for questions regarding insurance benefits. Ensure timely turnaround to prevent treatment delays as insurance plans and benefit structures change frequently.

Required Qualifications

  • clinical knowledge of services
  • expert knowledge of insurance plans
  • expert knowledge of insurance regulations
  • expert knowledge of insurance benefit and coverages
  • quarterly or as needed onsite attendance for training purposes

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