Remote Prior Authorization & Insurance Verifier

BMC Software; United States; Remote; USD 36,000 - 43,000; Part time

Job summary

Boston Medical Center is seeking a Part-Time Prior Authorization Specialist to screen and coordinate preauthorization requests for inpatient, outpatient, and ancillary services. The role emphasizes timely financial clearance, adherence to policies, and collaboration with physicians, patients, and payer representatives.

The position supports the insurance verification workflow, answers calls, and ensures accurate documentation in Epic and related systems while maintaining confidentiality and a

Qualifications

• Minimum 4–5 years of office experience in high volume data entry or health care setting.
• Experience with insurance payer websites (e.g., BCBS, Medicare).
• Experience with insurance verification, prior authorization and financial clearance.
• Bilingual preferred.

Responsibilities

• Prioritize incoming Prior Authorization requests and process them per policy.
• Verify member eligibility and enter data in CCMS or Facets to complete requests.
• Refer complex cases to clinicians or management for review.
• Maintain productivity and quality targets with a full caseload.
• Coordinate with patients, providers and departments on authorization requirements.

Skills

High volume processing

Epic knowledge

Communication skills

Confidentiality

Financial clearance process

Education

High school diploma or GED

Associate degree preferred

Tools

Epic

CCMS

Facets

Microsoft Excel

Job description

Boston Medical Center is seeking a Part-Time Prior Authorization Specialist to screen and coordinate preauthorization requests for inpatient, outpatient, and ancillary services. The role emphasizes timely financial clearance, adherence to policies, and collaboration with physicians, patients, and payer representatives.

The position supports the insurance verification workflow, answers calls, and ensures accurate documentation in Epic and related systems while maintaining confidentiality and a