Healthcare Billing and Benefits Coordinator

Men's Health Boston is a leading multi-specialty men's health medical practice dedicated to providing exceptional, patient-centered care. Our growing team works collaboratively to deliver innovative treatment plans that improve the health and well-being of our patients. We are seeking a detail-oriented, organized, and proactive Healthcare Benefits Coordinator to support our clinical and administrative teams by ensuring timely insurance verification, prior authorizations, and claims management.

Position Summary

The Healthcare Benefits Coordinator plays a vital role in helping patients access the care they need by managing insurance-related processes efficiently and accurately. This individual will verify insurance benefits, obtain prior authorizations, oversee claim submission and follow-up, and serve as a liaison between patients, providers, and insurance companies to resolve coverage and reimbursement issues.

The ideal candidate is highly organized, enjoys problem-solving, communicates effectively with patients and insurance carriers, and thrives in a fast-paced healthcare environment.

Responsibilities

• Verify patient insurance eligibility and benefits prior to appointments and procedures
• Obtain and manage prior authorizations for medications, diagnostic testing, and medical services
• Prepare, submit, monitor, and follow up on insurance claims to ensure timely reimbursement
• Research and resolve denied or outstanding claims by communicating with insurance carriers and internal staff
• Communicate insurance coverage, authorizations, and financial responsibilities to patients
• Maintain accurate documentation within the electronic medical record (EMR) and practice management system
• Collaborate closely with physicians, clinical staff, and billing personnel to ensure seamless patient care
• Stay current on payer policies, insurance regulations, and authorization requirements
• Identify opportunities to improve insurance workflows and reimbursement processes
• Utilize AI tools and technology to improve efficiency, documentation, and administrative workflows

Qualifications

• Minimum of 3 years of experience in a medical office, healthcare administration, or insurance coordination role
• Strong knowledge of commercial insurance, Medicare, and prior authorization processes
• Experience with insurance claim submission, claim follow-up, and denial resolution
• Familiarity with electronic medical records (EMR) and practice management software
• Excellent organizational skills with exceptional attention to detail
• Strong communication and customer service skills
• Ability to manage multiple priorities while maintaining accuracy
• Proficiency with Microsoft Office and familiarity with video conferencing platforms (Zoom, Microsoft Teams, Google Meet, etc.)
• Comfortable using AI tools to improve productivity and workflow efficiency

Preferred Qualifications

• Experience in a specialty medical practice
• Knowledge of men's health, hormone replacement therapy, or GLP-1 medication authorization processes
• Experience working with multiple insurance carriers and pharmacy benefit managers (PBMs)