Talent.com
Authorization Specialist
Authorization SpecialistNew England Life Care • Canton, MA, US
Authorization Specialist

Authorization Specialist

New England Life Care • Canton, MA, US
14 days ago
Job type
  • Full-time
Job description

Job Description

Job Description

New England Life Care (NELC) is one of the fastest growing home infusion therapy companies in New England and is the region’s only non-profit home infusion provider. NELC is a hospital collaborative serving more than 70 hospital systems in Maine, New Hampshire, and Massachusetts. NELC was created by local hospitals to ensure their patients have access to a provider that reflects their commitment to excellence in patient care, quality, and service. Like our owner hospitals, NELC provides patient focused care.

New England Life Care has and continues to build a diverse, inclusive, and authentic workplace, so if you’re energized by this opportunity, but your experience doesn’t support every qualification in the job posting, we encourage you to apply! You still may be the person we are looking for!

New England Life Care currently has a Remote Authorization Specialist position available. The normal schedule is Monday – Friday from 8 : 30am to 5 : 00pm .

The ideal candidate for this role will have at least three years of authorization or billing experience.

  • Only hiring for this remote role in the following states : Maine, Massachusetts, New Hampshire, Maryland, North Carolina, Connecticut, and Florida

Job Summary :

The Remote Authorization Specialist is responsible for obtaining and maintaining prior authorization status for NELC patient medications / therapies. The authorization specialist works closely with the clinical review department to obtain documentation needed to complete the authorization process. The authorization specialist also obtains needed documentation to support the billing department in meeting payer requirements for patient accounts.

Career Ladders : NELC’s reimbursement department offers career ladders to Authorization Specialists. Candidates who achieve excellent performance in their job duties, who demonstrate a commitment to personal development, participation in department and company strategic programs and projects, who develop superior working relationships inside and outside the department and who show a commitment to the success of the department are eligible for promotion to the following positions :

Authorization Specialist – represents an entry level position into the department. Candidates who meet defined goals, objectives and accomplishments can generally expect to be promoted in 2-3 years to :

Senior Authorization Specialist – Candidates who meet defined goals, objectives, and accomplishments and who demonstrate engagement and ownership of departmental and organization activities would generally expect to be promoted in 4-5 years to :

Lead Authorization Specialist – Candidates who are part of the department leadership team and who have responsibility for advanced departmental, company and member hospital engagement.

Benefits :

  • Remote position
  • Room for growth and potential for advancement
  • Health insurance
  • Dental insurance
  • Vision insurance
  • Generous employer-matched 403b savings program
  • Company paid : Life insurance, Short- and long-term disability insurance
  • Paid time off
  • And much more!
  • Responsibilities :

  • Achieve performance appraisals with "meets expectations" or better
  • Maintain a good record of attendance and punctuality
  • No Performance management deficiencies in the period
  • Demonstrate independence and competence to follow Authorization Request process for all payers.
  • Demonstrate independence and competence to follow the Re-Authorization process
  • Demonstrate independence and competence to follow the Specialty process
  • Demonstrate independence and competence on all MOA's and therapies
  • Demonstrate independence and competence and ability to Authorize all services, document and communicate accurately on all changes of service, in CPR+ and to appropriate departments.
  • Demonstrate independence and competence and ability to work through a TO DO without the need for extended timeframes.
  • Demonstrates the ability to work within a team and independently with confident communication skills and exceptional customer service skills.
  • Completes three continuing education programs in the period specifically related to professional development, LEAN and / or leadership development.
  • Education :

  • High School Diploma, or equivalent required.
  • Minimum of 2 years authorization, reimbursement or claims processing experience required.
  • Practical experience with medical terminology; CPT, ICD-9 and HCPC coding preferred.
  • Practical experience with Medicare, Medicaid and third-party payor contracts preferred
  • Knowledge of HIPAA Privacy and Security requirements preferred.
  • Skills :

  • Excellent organizational skills required.
  • Basic accounting transaction / analyst skills required.
  • Demonstrated ability to identify research and solve problems required.
  • Ability to work independently as well as part of a team required.
  • Practical experience with Microsoft computer systems and applications, to include Word & Excel
  • ''It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment.

    An employer who violates this law shall be subject to criminal penalties and civil liability.''

    EOE

    Monday – Friday from 8 : 30am to 5 : 00pm

    Create a job alert for this search

    Authorization Specialist • Canton, MA, US

    Related jobs
    Prior Authorization Specialist

    Prior Authorization Specialist

    VirtualVocations • Dorchester, Massachusetts, United States
    Full-time
    A company is looking for a Prior Authorization Assistant to support their AI-powered prior authorization solution in healthcare operations. Key Responsibilities Review and verify insurance informa...Show more
    Last updated: 30+ days ago • Promoted
    Travel - X-Ray Tech

    Travel - X-Ray Tech

    Titan Medical Group • Greenbush, MA, US
    Full-time
    WHEN YOU WORK FOR US, WE WORK FOR YOU\n.With Titan Medical, you gain access to thousands of travel nursing and allied health jobs across the country. You also get unmatched service.From the moment y...Show more
    Last updated: 1 day ago • Promoted
    Authorization Specialist - Missouri

    Authorization Specialist - Missouri

    VirtualVocations • Cranston, Rhode Island, United States
    Full-time
    A company is looking for an Authorization Specialist - RCM.Key Responsibilities Validate patient information, scheduled tests / surgeries, and insurance details to ensure accurate authorization rec...Show more
    Last updated: 4 days ago • Promoted
    Arbitration Specialist

    Arbitration Specialist

    VirtualVocations • Cranston, Rhode Island, United States
    Full-time
    A company is looking for an Arbitration Specialist responsible for analyzing claims eligible for arbitration and managing related tasks. Key Responsibilities Analyze claim reports to determine eli...Show more
    Last updated: 25 days ago • Promoted
    Telemedicine Physician

    Telemedicine Physician

    QuickMD • Scituate, MA, US
    Full-time
    QuickMD is a leading telemedicine provider, delivering high-quality virtual care across 44 states.Since our founding in 2019, we have helped more than 100,000 patients access essential medical trea...Show more
    Last updated: 30+ days ago • Promoted
    Title Specialist

    Title Specialist

    VirtualVocations • Cranston, Rhode Island, United States
    Full-time
    A company is looking for a Title Specialist to join their Title Operations team.Key Responsibilities : Validate information and enter data into the proprietary system to open orders Generate titl...Show more
    Last updated: 4 days ago • Promoted
    Pre-Service Authorization Specialist

    Pre-Service Authorization Specialist

    VirtualVocations • Dorchester, Massachusetts, United States
    Full-time
    A company is looking for a Pre Service IV Auth Specialist.Key Responsibilities Secure pre-authorizations from insurance companies for various healthcare services Respond to clinical inquiries th...Show more
    Last updated: 3 days ago • Promoted
    ABA Director of Authorizations

    ABA Director of Authorizations

    VirtualVocations • Cranston, Rhode Island, United States
    Full-time
    A company is looking for a Director of Authorizations and Client Intake.Key Responsibilities Oversee the client intake process and ensure a smooth transition for new clients Manage the authoriza...Show more
    Last updated: 1 day ago • Promoted
    Insurance Verification Specialist

    Insurance Verification Specialist

    VirtualVocations • Cranston, Rhode Island, United States
    Full-time
    A company is looking for an Insurance Verification and Authorization Specialist.Key Responsibilities Verify new patient accounts and review insurance benefits for accuracy Utilize payor portals ...Show more
    Last updated: 30+ days ago • Promoted
    Portfolio Lead Solution Architect Director

    Portfolio Lead Solution Architect Director

    Boston Consulting Group • Scituate, MA, US
    Full-time
    Boston Consulting Group partners with leaders in business and society to tackle their most important challenges and capture their greatest opportunities. BCG was the pioneer in business strategy whe...Show more
    Last updated: 4 days ago • Promoted
    ABA Compliance Specialist

    ABA Compliance Specialist

    VirtualVocations • Cranston, Rhode Island, United States
    Full-time
    A company is looking for an ABA Compliance Specialist to ensure adherence to internal policies and industry regulations related to ABA therapy services. Key Responsibilities : Monitor and ensure co...Show more
    Last updated: 5 days ago • Promoted
    Risk Specialist

    Risk Specialist

    Enbridge Inc. • Waltham, MA, United States
    Full-time +1
    If you a project management professional who has risk management experience come join Enbridge today.In return, we offer opportunities for growth, a competitive benefits and pension plan, and gener...Show more
    Last updated: 2 days ago • Promoted
    U.S. Border Patrol Agent

    U.S. Border Patrol Agent

    U.S. Customs and Border Protection • Bliss Corner, MA, US
    Full-time
    Customs and Border Protection (CBP) offers those interested in a career in law enforcement an exceptional opportunity to work with an elite team of highly trained professionals whose camaraderie, p...Show more
    Last updated: 1 day ago • Promoted
    Authorization & Billing Specialists

    Authorization & Billing Specialists

    Ophthalmic Consultants of Boston • Plymouth, MA, US
    Permanent
    Ophthalmic Consultants if Boston is currently looking for Authorization Billing Specialists to join our team in Plymouth. These specialists provide administrative and billing support to ...Show more
    Last updated: 30+ days ago • Promoted
    Border Patrol Agent

    Border Patrol Agent

    U.S. Customs and Border Protection • Marshfield Hills, MA, US
    Full-time
    Customs and Border Protection (CBP) offers those interested in a career in law enforcement an exceptional opportunity to work with an elite team of highly trained professionals whose camaraderie, p...Show more
    Last updated: 1 day ago • Promoted
    Award Management Specialist

    Award Management Specialist

    VirtualVocations • Cranston, Rhode Island, United States
    Permanent
    A company is looking for an Award Management Officer to manage and ensure compliance for sponsored awards in a remote setting. Key Responsibilities Evaluate incoming award terms and conditions, id...Show more
    Last updated: 4 days ago • Promoted
    Pre-Authorization Specialist

    Pre-Authorization Specialist

    VirtualVocations • Dorchester, Massachusetts, United States
    Full-time
    A company is looking for a Pre-Authorization Specialist.Key Responsibilities Identify prior authorization requirements by insurance / payer and process pre-authorizations for scheduled and add-on s...Show more
    Last updated: 30+ days ago • Promoted
    Global Complaint Resolution Manager

    Global Complaint Resolution Manager

    Sentec • Lincoln, RI, US
    Full-time
    Global Complaint Resolution Manager.This role provides functional leadership to a team of complaint specialists, ensuring regulatory compliance, process optimization, and continuous improvement.The...Show more
    Last updated: 22 days ago • Promoted