[Hiring] Financial Access Specialist @Mass General Brigham

Role Description

Under the direction of the Patient Access Manager, the Financial Access Specialist is responsible for financial clearance of assigned post-acute admissions within the Financial Access Department, supporting inpatient Acute Rehabilitation (IRF), Long Term Acute Care (LTAC), and Skilled Nursing Facility (SNF) levels of care across Spaulding Rehabilitation facilities. This role verifies insurance eligibility, coverage, and benefits, and manages prior authorizations from initiation through final determination. The Financial Access Specialist ensures accurate documentation within Epic and works collaboratively with Admissions, Case Management, Financial Counseling, leadership, and other departments to ensure timely admissions and financial accountability aligned with organizational goals and system-wide objectives.

Essential Functions

• Responsible for financial clearance of assigned post-acute admissions, including verification of insurance eligibility, coverage, and benefits.
• Initiates and manages prior authorization requests from submission through final determination.
• Ensures all authorization activity is thoroughly documented in Epic (Auth/Cert).
• Identifies benefit limitations, network concerns, out-of-network scenarios, and other financial risks.
• Negotiates single case agreements with Workers’ Compensation carriers and non-contracted payers.
• Responsible for monitoring and prioritizing assigned Epic Workqueues.
• Communicates authorization updates, insurance requests for additional information, peer-to-peer offers, appeals, and denials.
• Maintains and resolves errors and required edits within Epic Patient and Account Workqueues.
• Prepares self-pay cost estimates when applicable and collaborates with Financial Counseling.
• Accurately records authorization determinations and approval details.
• Works collaboratively with Admissions, Case Management, Financial Counseling, and leadership.

Qualifications

• High School Diploma or equivalent required.
• Bachelor's degree preferred.
• 2+ years of experience required in patient access/hospital registration or revenue cycle.
• Epic experience is strongly preferred.
• Experience with prior authorizations and insurance verifications strongly preferred.
• Knowledge of medical terminology, insurance plans, and reimbursement processes.
• Familiarity with healthcare regulations, including HIPAA.
• Excellent communication and interpersonal skills.
• Strong attention to detail and organizational skills.
• Ability to work independently and as part of a team in a fast-paced environment.

Requirements

• Remote, requires a quiet, secure, HIPAA-compliant work station.
• Occasional weekends required (one Saturday shift 10am - 2pm monthly, subject to change).

Benefits

• Competitive base pay.
• Comprehensive benefits.
• Career advancement opportunities.
• Differentials, premiums, and bonuses as applicable.
• Recognition programs designed to celebrate contributions and support professional growth.