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Authorization Spec-Surg-Ancillary

L5

southcoast health systemNew Bedford, MA3 days ago

Occupations

Medical Records SpecialistsHealth Information Technologists and Medical RegistrarsMedical Secretaries and Administrative Assistants

Industries

General Medical and Surgical HospitalsSpecialty HospitalsOffices of Physicians
Overview: In this role you will drive revenue integrity by obtaining and securing authorizations for surgical and ancillary services. You will collaborate with patients, physicians, and payers to clarify coverage, estimate patient liability, and secure pre-certifications, ensuring compliance and smooth access to care. You will work with cross-functional teams to optimize authorization workflows and support the rehab department. This is a mission-driven position at a respected health system that values growth and patient-centered care. Compensation / Benefitscompetitive pay and comprehensive benefits package Generous Earned Time OffEmployee Wellbeing Program403B Retirement Plan with company matchtuition assistance / Federal Loan Forgiveness programsprofessional growth opportunities and customized leadership training
Responsibilities:
  • Enter and manage orders, schedule/cancel/reschedule appointments, and determine patient liability with payer-based estimates
  • Obtain pre-certification and authorization for inpatient and outpatient services by contacting third party payers
  • Coordinate with payers and providers, including peer-to-peer discussions, to authorize high-cost services
  • Ensure CPT codes are documented and authorized for the appropriate services
  • Partner with Care Coordination to determine appropriate level of care
  • Navigate multiple payer portals to determine requirements and submit electronic requests
  • Collaborate with Pharmacy to authorize infusion medications and related services
  • Follow up on payer denials with supporting clinical data for appeals
  • Verify coverage and authorize new patients for SE Rehab Department
Key requirements:
  • Associates Degree in a related field (Bachelor's preferred)
  • Certificate in Medical Terminology preferred
  • Coding experience preferred
  • Typing speed 40 wpm
  • Strong customer service skills
  • Effective communication with physicians, patients, and payers
  • Proficiency navigating multiple payer portals and web-based tools
  • Over three years of healthcare experience focusing on revenue cycle activities preferredcustomer service orientationclear communicationproblem solvingproficiency with payer portals and web-based toolscoding experience
  • Medical Terminology certificate (preferred)
Apply now (opens in a new tab)
Apply now (opens in a new tab)

Level

SeniorL5

Location

New Bedford, MA

Occupation

Medical Records Specialists

Industry

General Medical and Surgical Hospitals

Posted

3 days ago

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