Remote Prior Authorization and Insurance Verification

Boston Medical Center (BMC); United States; Remote; USD 36,000 - 43,000; Part time

Job summary

Boston Medical Center is seeking a Part-Time Insurance Verification Specialist to screen prior-authorization requests and coordinate financial clearance. This remote role supports the Insurance Verification department, handling patient data, authorizations, and referrals to ensure timely access to services.

Responsibilities include verifying eligibility, guiding clinicians, and maintaining compliance with policies while delivering quality customer service to patients and providers.

Qualifications

• High school diploma or GED required.

Responsibilities

• Prioritizes incoming Prior Authorization requests.
• Processes authorization requests and forwards those needing clinical judgment to clinicians.
• Meets or exceeds productivity and quality metrics within turn-around timeframes.
• Answers ACD lines and verifies member eligibility; records information in CCMS or Facets.
• Identifies network providers, services and member benefits.
• Coordinates resolution of escalated member/provider inquiries.
• Works with patients, providers and departments to explain Prior Authorization requirements.
• Maintains knowledge of member handbooks and evidence of coverage.
• Ensures required financial clearance elements are obtained prior to visits.
• Collaborates with practices, physicians and payers to obtain and record referrals and authorizations.
• Escalates denied accounts per policy and maintains confidentiality of records.
• Maintains compliance with confidentiality laws and organizational policies.

Skills

Bilingual preferred

High volume data entry

Customer service excellence

Oral and written communication

Ability to work under pressure

Epic knowledge

Education

High school diploma or GED

Associate’s degree or higher preferred

Tools

Epic

Microsoft Excel

Microsoft Word

Outlook

Zoom

Job description

Boston Medical Center is seeking a Part-Time Insurance Verification Specialist to screen prior-authorization requests and coordinate financial clearance. This remote role supports the Insurance Verification department, handling patient data, authorizations, and referrals to ensure timely access to services.

Responsibilities include verifying eligibility, guiding clinicians, and maintaining compliance with policies while delivering quality customer service to patients and providers.