Insurance Prior Authorization Jobs in Boston, MA

The intake specialist manages various aspects of the in-take process, ensuring the efficient financial clearance of emergency and non-emergency Ambulance transports. They review patient care reports, verify insurance, and assist patients with billing inquiries. They work closely with Communications/Dispatch, patients, and insurance providers to facilitate proper documentation, insurance authorizations, and payments, ultimately ensuring the seamless provision of our life-saving services
Key Responsibilities

• Will Call Management: Handle incoming calls from patients and medical facilities to schedule non-emergency ambulance services, ensuring accurate and efficient scheduling of trips.
• Insurance Verification: Confirm patient eligibility and benefits with private insurance carriers, Medicare, and Medicaid
• Insurance Documentation: Verify and collect necessary insurance information from patients and facilities, including but not limited to insurance cards, policy numbers, and patient demographics.
• Insurance Prior Authorizations: Communicate with insurance providers to secure prior authorizations for ambulance services, following up as needed to ensure timely approval.
• Billing Information: Enter complete and accurate patient and trip information into the company's billing system and maintain detailed records of all transactions and communications.
• Patient Support: Address customer service inquiries, explain the ambulance billing and collections process, and establish payment plans
• Compliance & Privacy: Ensure all activities and documentation adhere to company policies, healthcare regulations, and insurance requirements. Strictly adhering to HIPAA regulations, maintaining the confidentiality of sensitive medical and financial data.
• Team Collaboration: Collaborate closely with Dispatch to ensure trips are financially cleared in a timely and organized manner, allowing for the efficient dispatch of ambulance units.
• Customer Service: Provide exceptional customer service by addressing facility/patient inquiries, resolving issues, and maintaining a professional and empathetic demeanor during all interactions.
• Consistently meets and maintains productivity goals and defined benchmarks on a weekly basis.
• Additional projects and responsibilities as assigned and requested.
• Maintains knowledge of and complies with all company policies, procedures, and guidelines at all times.

• High school diploma or GED equivalent is required. Post-secondary certification in medical billing or coding (CPB from AAPC or other) highly preferred.
• 1-3 years of Medical Billing experience
• Prior experience in EMS, Ambulance, transportation Medical billing preferred

• Not Applicable to this role as a requirement

• Knowledge of HIPPA and Healthcare standards
• Deep understanding of Medicaid and Medicare Ambulance Guidelines, as well as private insurance reimbursement protocols.
• Proficiency with medical billing software, electronic health records (HER) systems
• Working knowledge of Web based applications and Microsoft Office, including Excel and Word required
• Communicate effectively, both verbally and in writing; ability to understand and carry out verbal and written instructions.
• Analytical skills to gather and interpret data
• Ability to exercise sound judgment and discretion at all times
• Strong interpersonal skills
• Excellent organization skills: attention to detail and follow-through
• Resolve issues quickly and efficiently
• Able to multitask, take charge and ownership of tasks
• Ability to work independently and in a team setting
• Handle highly confidential information with complete discretion
• Ability to work in a Fast paced, high demand environment

• Must be minimum of 18 years of age

• Ability to meet the essential duties and physical, mental and sensory requirements of the position at all times.
• Comply with UDS drug screening at any and all times

• Completion and receipt of satisfactory background check and MA CORI (Criminal Offender Record Information), verification may be required annually.

• Stationary Position: Frequently required to sit for long periods at a desk.
• Manual Dexterity: High level of finger dexterity to operate computers, calculators, and office machinery.
• Handling/Reaching: Frequent need to reach with hands/arms, handle files, and feel objects.
• Lifting/Moving: Ability to lift, carry, or move documents, files, or office equipment (typically up to 10-25 pounds).
• Movement: Intermittent walking, standing, bending, or stooping to access files

• Organization: Exceptional organizational and time-management skills to handle daily tasks.
• Attention to Detail: Ability to input data accurately and read fine statistical reports.
• Communication: High-level verbal and written communication skills, including professional telephone etiquette.
• Problem-Solving: Ability to manage deadlines and resolve issues

• Vision: Close vision, peripheral vision, depth perception, and ability to adjust focus to read computer screens and printed documents.
• Hearing: Ability to hear and understand speech in person and on the telephone.
• Speech: Ability to communicate clearly in person and via phone.