Financial Access Specialist
 Spaulding Hospital - Boston and Cambridge | |
$28.30 / hr
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 United States, Massachusetts, Boston | |
| 300 1st Avenue (Show on map) | |
 Sep 29, 2026 | |
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Site: The Spaulding Rehabilitation Hospital Corporation
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job Summary SummaryThe role is responsible for financial clearance of assigned postacute admissions across the full continuum of care within the Department, encompassing inpatient IRF, LTAC, SNF, and outpatient Therapy and Physical Medicine services across Spaulding Rehabilitation facilities. This role verifies insurance eligibility, coverage, and benefits, and manages prior authorizations from initiation through final determination. The role ensures accurate documentation in Epic and collaborates with departments such as Admissions, Case Management, Financial Counseling, and Outpatient Rehabilitation teams (administrative and clinical). The role supports timely access for patients receiving inpatient care, outpatient therapy, or outpatient procedures while maintaining financial accountability aligned with organizational goals and systemwide objectives. Does this position require Patient Care? No Essential Functions -Responsible for financial clearance of assigned postacute and outpatient services, including verification of insurance eligibility, coverage, and benefits for inpatient admissions, outpatient therapy, and outpatient procedures as assigned. -Initiates and manages prior authorization requests from submission through final determination. This includes submitting required clinical documentation, conducting routine status checks through payer portals and direct communication with payers, confirming authorization details with payers when applicable, and ensuring the timely progression of each case. -Ensures all authorization activity and approval details are thoroughly documented in Epic, providing visibility across departments and supporting accurate reimbursement. -Identifies benefit limitations, network concerns, out-of-network scenarios, and other financial risks, escalating to the Manager or Financial Counselor when appropriate. -Negotiates single case agreements with Workers' Compensation carriers and non-contracted payers as needed, including preparation of cost estimates and participation in reimbursement discussions to secure appropriate payment terms. -Responsible for monitoring and prioritizing assigned Epic Workqueues to support timesensitive inpatient admissions, outpatient therapy visits, and outpatient procedures as assigned, ensuring efficient referral throughput. -Communicates authorization updates, insurance requests for additional information, peer-to-peer offers, appeals, and denials to relevant stakeholders. -Prepares self-pay cost estimates when applicable and collaborates with Financial Counseling to ensure financial clearance prior to inpatient admission, outpatient therapy or outpatient procedures. Qualifications Education - Proficiency in Epic strongly preferred, including workqueue management and authorization documentation. - Knowledge of prior authorization workflows and payer portal navigation. - Excellent attention to detail with strong organizational and time-management skills, including the ability to manage multiple priorities in a time-sensitive environment. - Ability to build effective working relationships across departments and work effectively within a team environment to support coordinated admission and authorization processes. - Demonstrated ability to handle sensitive patient information and maintain strict confidentiality in accordance with HIPAA regulations. - Ability to work independently and exercise sound judgment within established policies and procedures. - Strong communication and interpersonal skills with the ability to effectively collaborate with colleagues, leadership, insurance case managers, and payer representatives. Additional Job Details (if applicable) Physical RequirementsRemote Type Work Location Scheduled Weekly Hours Employee Type Work Shift Pay Range $ - $28.30/HourlyGrade 3 At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.EEO Statement: At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline. | |