Addiction Recovery Program Insurance Coordinator/Resource Specialist

Site: Brigham and Women's Physicians Organization, Inc.

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Job Summary

Addiction Recovery Program Insurance Coordinator & Resource SpecialistHelp patients access compassionate, coordinated substance use disorder care at Brigham and Women’s Faulkner Hospital.Make an ImpactJoin our interdisciplinary addiction medicine team and help patients navigate admission, insurance authorization, treatment resources, and next-step care. You will support patients across the ASAM Level 4 ATS unit, emergency department, and medical and surgical services while keeping daily operations and care transitions moving smoothly.The Addiction Recovery Program Insurance Coordinator and Resource Specialist supports the addiction medicine team at Brigham and Women’s Faulkner Hospital, serving patients on the ASAM Level 4 ATS/“detox” unit, in the emergency department, and on medical and surgical services. Working with an MD, social workers, and a recovery coach, this role manages daily unit operations, admission requests, patient intakes, case presentations, and insurance authorizations. The role also assists with resources and aftercare planning, including community detox placement and partial hospital or intensive outpatient programs.PRINCIPAL DUTIES AND RESPONSIBILITIES 

• * Manage the ATS phone line by answering patient calls during work hours and returning voicemails about direct admission.
• * Coordinate with the emergency department for patients interested in ATS admission.
• * Verify ATS insurance coverage and submit authorization after clinical acceptance.
• * Complete a standardized substance use intake and present the patient to the attending physician for an admission decision.
• * Coordinate with the patient, admitting staff, and nursing staff to schedule direct admission.
• * Complete prior authorizations for medically necessary stay extensions.
• * Attend the interdisciplinary team meeting Monday–Friday at 1 p.m. to review care and disposition plans.
• * Partner with ATS and addiction consult clinicians to transition patients to further treatment, following clinical leadership and coordinating care and resource use.
• * Refer patients to appropriate levels of care by providing required clinical documentation, coordinating facility transfers and intake appointments, arranging outpatient follow-up, and helping patients obtain a PCP when needed.
• * Build effective relationships with internal programs, outside agencies, facilities, payors, and community resources to support patient and family disposition plans.
• * Perform other duties as directed to support patient care.
• * Educate patients about available resources and SUD services, clarify care goals, and help reduce barriers to achieving them.
• * Provide flexible support as patient goals or plans change.
• * Collaborate with ATS clinicians to identify needed supports and connect patients with services.
• * Explain financial services and self-pay resources as needed.
• * Follow federal and state requirements and obtain appropriate releases before sharing patient information.
• * Provide practice staff coverage as needed.
• * Perform related tasks that improve patient flow or quality of care.
• * Document all in-person and phone care-coordination communications in the MGB electronic medical record.

  Qualifications

  What You’ll Do

  • Manage admission inquiries, complete substance use intakes, and present cases for clinical review.
  • Verify insurance coverage and complete initial and continued-stay authorizations.
  • Coordinate admissions, transfers, aftercare, outpatient follow-up, and access to community resources.
  • Educate and advocate for patients while collaborating with clinicians, payors, facilities, and community partners.
  • Document care coordination in the electronic medical record and support patient flow and practice operations.

  What You’ll Bring

  • Associate degree required; bachelor’s degree preferred.
  • Two to three years of mental health care experience preferred, especially in substance use disorders.
  • Strong communication, collaboration, customer service, advocacy, organization, and time-management skills.
  • Sound judgment and the ability to work independently, multitask, solve problems, and adapt in a fast-paced environment.
  • Strong computer skills and familiarity with addiction treatment, systems of care, and community resources.

  Additional Job Details (if applicable)

  Schedule & Location

  Monday–Friday, 11 a.m.–7 p.m.100% onsite at Brigham and Women’s Faulkner Hospital.

  Remote Type

  Onsite

  Work Location

  1153 Centre Street

  Scheduled Weekly Hours

  40

  Employee Type

  Regular

  Work Shift

  Day (United States of America)

  Pay Range

  $25.50 - $36.49/Hourly

  Grade

  5At 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:

  2410 Brigham and Women's Physicians Organization, 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

  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.