Financial Access Specialist

Site: The Spaulding Rehabilitation Hospital Corporation

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Job Summary
Summary

The role is responsible for financial clearance of assigned post‑acute 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 system‑wide objectives.

Does this position require Patient Care? No

Essential Functions

-Responsible for financial clearance of assigned post‑acute 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 time‑sensitive 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
Associate's Degree Related Field of Study required

Can this role accept experience in lieu of a degree?
Yes

Licenses and Credentials

Experience
Patient access, hospital registration, or revenue cycle experience 2-3 years required

Knowledge, Skills and Abilities

- 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 Requirements
- Standing Occasionally (3-33%)

- Walking Occasionally (3-33%)

- Sitting Constantly (67-100%)

- Lifting Occasionally (3-33%) 20lbs - 35lbs

- Carrying Occasionally (3-33%) 20lbs - 35lbs

- Pushing Rarely (Less than 2%)

- Pulling Rarely (Less than 2%)

- Climbing Rarely (Less than 2%)

- Balancing Occasionally (3-33%)

- Stooping Occasionally (3-33%)

- Kneeling Rarely (Less than 2%)

- Crouching Rarely (Less than 2%)

- Crawling Rarely (Less than 2%)

- Reaching Occasionally (3-33%)

- Gross Manipulation (Handling) Constantly (67-100%)

- Fine Manipulation (Fingering) Frequently (34-66%)

- Feeling Constantly (67-100%)

- Foot Use Rarely (Less than 2%)

- Vision - Far Constantly (67-100%)

- Vision - Near Constantly (67-100%)

- Talking Constantly (67-100%)

- Hearing Constantly (67-100%)

Remote Type
Remote

Work Location
300 First Avenue

Scheduled Weekly Hours
40

Employee Type
Regular

Work Shift
Day (United States of America)

Pay Range
$ - $28.30/Hourly

Grade
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:
1400 The Spaulding Rehabilitation Hospital Corporation 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.

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