{"id":3895388,"url":"https://alion.io/job/mass-general-brigham-billing-managed-care-coordinator-lead","title":"Billing Managed Care Coordinator Lead","company":{"id":5797,"name":"Mass General Brigham","domain":"massgeneralbrigham.org","url":"https://alion.io/company/massgeneralbrigham","size_band":"5000+","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Workday","truth_index":{"grade":"B","score":84,"open_postings":139,"ghost_share":0,"stale_share":0.64,"repost_share":0.014,"time_to_fill_p50_days":24,"computed_at":"2026-11-12T10:38:37Z"}},"role":"Administrative","role_family":"Administrative","seniority":"lead","employment_type":"full_time","work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"posting_text","remote_working_hours":null,"hiring_geo_confidence":"explicit","locations":["Boston, United States"],"countries":["US"],"hiring_countries":["US"],"hiring_countries_total":1,"salary":{"min":25,"max":36,"currency":"USD","period":"hour","gross":null,"usd_annual":72000},"salary_estimate":null,"experience_years_min":3,"visa_sponsorship":true,"relocation_package":false,"has_equity":false,"technologies":[{"name":"HIPAA","optional":false}],"status":"closed","first_seen_at":"2026-11-06T22:59:09Z","employer_posted_date":"2026-11-06","last_verified_at":"2026-11-11T13:47:22Z","board_verified":false,"closed_at":"2026-11-11T13:47:22Z","days_open":4,"trust":{"level":"not_scored","repost_count":null,"flags":[],"days_open":4},"description":"Site: The Brigham and Women's Hospital, Inc.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.\nJob Summary\nResponsible for overseeing prior authorization and referral requests for medical services, including insurance eligibility verification, referrals for specialty care, medical necessity review, and compliance with payer, company, and HIPAA requirements. Reviews, compiles, submits, and documents all required medical records and authorization details in the EHR, maintaining accurate communication with payers and third-party administrators. Leads and supports a team by collaborating across departments, precepting new hires, and conducting proactive and reactive audits to ensure timely processing, compliance, and continuous process improvement.Does this position require Patient Care? No\nEssential Functions:\n-Oversee daily operations of the prior authorization and referral department. Lead, mentor, and train team members, ensuring efficient workflow and adherence to policies and procedures.\n-Regularly review Epic and Tableau dashboards, including but not limited to work queue monitoring reports to forecast staffing needs.\n-Ensure compliance with payer requirements, healthcare regulations, and facility policies in all prior authorization activities, including tests and imaging, is collected, reviewed, and submitted accurately and promptly to insurance companies and other payers.\n-Inform patient of authorization concerns prior to admission/procedure, coordinating with appropriate parties to facilitate authorization as appropriate, collaborating with other departments/offices to resolve complex authorization issues.\n-Develop and implement process improvements to enhance efficiency and reduce authorization turnaround times.\n-Address and resolve complex authorization denials and appeals, working with providers, patients, and payers to achieve favorable outcomes.\n-When unclear, collaborates with ordering clinicians to ensure the proper CPT codes are submitted for prior authorization or referrals.\n-Refer patients to financial counseling, as appropriate.\n Qualifications\nEducation: High school diploma or equivalent is required.\nPreferred Education: Associate’s degree in related field.\nExperience in lieu of degree: No. Candidates must meet the minimum education requirement.\nHealthcare Experience: 3-5 years required in: Prior authorization medical billing or a related healthcare role,\nLeadership/Supervisory Experience: 1-2 years preferred.\nEpic Experience: 1-2 years required \nKnowledge, Skills and Abilities\n- In-depth knowledge of prior authorization processes, payer requirements, and healthcare regulations. \n- Strong leadership, management, and team-building skills. \n- Excellent communication and interpersonal skills, with the ability to interact effectively with providers, patients, and insurance representatives. \n- Proficiency in electronic health records (EHR) systems and prior authorization software. \n- Strong analytical and problem-solving abilities, excellent attention to detail, and organizational skills. \n- Ability to work in a fast-paced environment.\n Additional Job Details (if applicable)\nDepartment: BWH Radiology Referral and Prior Authorization Department\nSchedule: Monday - Friday | 7:30 am to 4pm| 100% remote, but candidate must reside in the United States.\nNo visa sponsorship available. Candidate must be authorized to work in the U.S. without current or future sponsorship.\nCompensation: The posted salary reflects the starting range for this position. Actual compensation will be based on the selected candidate's qualifications, including experience, education, and relevant skills.\nBenefits: Medical, Dental, Vision, 403b retirement plan, tuition reimbursement, discounted MBTA pass & more!\nRemote Type\nRemoteWork Location\n1620 Tremont StreetScheduled Weekly Hours\n40Employee Type\nRegular Work Shift\nDay (United States of America)Pay Range\n$25.50 - $36.49/HourlyGrade\n5At 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:\n2200 The Brigham and Women's Hospital, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642. Mass General Brigham Competency Framework\nAt 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.","description_format":"text","description_chars":6868,"description_truncated":false,"requirements":{"experience_years_min":3,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"high_school","optional":false},"security_clearance":false,"languages":[]},"benefits":["Retirement plans"],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["Hospitals & Health Systems","Health Insurance & Benefits"],"lifecycle":[{"event":"open","at":"2026-11-06T22:59:09Z"},{"event":"close","at":"2026-11-11T13:47:22Z"}],"visa":[{"country":"US","licensed_sponsor":true,"adverts_offering_sponsorship_24m":3,"sanctioned_now":false,"evidence":"H-1B filings in 12 months: 70","filings_12m":70,"filings_prev_12m":61,"green_card_filings_12m":0,"median_offered_wage_usd":87500,"route":null,"cap_exempt":false,"checked_at":"2026-11-12T07:36:15+00:00","sources":["US Department of Labor: LCA disclosure data (H-1B, H-1B1, E-3)","Alion: sponsorship offered in the employer's own job adverts (24 months)"],"filings_for_role_12m":0}],"liveness":null,"pay":{"stated_usd_annual":72000,"is_top_pay":true},"html_url":"https://alion.io/job/mass-general-brigham-billing-managed-care-coordinator-lead","json_url":"https://alion.io/job/mass-general-brigham-billing-managed-care-coordinator-lead.json","meta":{"generated_at":"2026-11-13T09:11:24Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":19010,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-11-14T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.1,"usd":0.01,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":5797},"rest":"https://alion.io/mcp/rest/get_company?id=5797"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fmass-general-brigham-billing-managed-care-coordinator-lead"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"free","price":{"credits":0,"usd":0},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fmass-general-brigham-billing-managed-care-coordinator-lead"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.1,"usd":0.01},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fmass-general-brigham-billing-managed-care-coordinator-lead"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/mass-general-brigham-billing-managed-care-coordinator-lead\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fmass-general-brigham-billing-managed-care-coordinator-lead"}],"agent":{"mcp":"https://alion.io/mcp/jobs","mcp_open":"https://alion.io/mcp/open","next":[{"tool":"get_job","arguments":{"id":3895388}},{"tool":"search_jobs","arguments":{"company":"massgeneralbrigham.org","detail":"compact"}},{"tool":"match_people","arguments":{"job_id":3895388},"note":"people open to offers who fit this vacancy"}],"note":"The same data through MCP tools: https://alion.io/mcp/open needs no sign-in (compact searches, postings, people); https://alion.io/mcp with an Alion account has everything. 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