Remote Prior Authorization Specialist

Boston Medical Center; Boston, Northern (MA, KY); Hybrid; USD 34,000 - 43,000; Part time

Job summary

Boston Medical Center is seeking a Prior Authorization Specialist I to join the Insurance Verification team in a remote, part-time capacity. The role focuses on screening prior authorizations, coordinating referrals, and ensuring timely financial clearance for inpatient, outpatient, and ancillary services.

The successful candidate will verify eligibility, navigate payer requirements, and support clinicians to maximize hospital reimbursement while maintaining high accuracy.

Qualifications

• High school diploma or GED required.
• Associate’s Degree or higher preferred.
• 4–5 years of office experience in high volume data entry or healthcare setting required.
• Experience with insurance verification, prior authorization, and financial clearance processes preferred.

Responsibilities

• Prioritize incoming Prior Authorization requests.
• Process requests and authorizations according to policies and workflows.
• Refer complex cases to clinicians or managers for review.
• Meet productivity and quality expectations while maintaining a full caseload.
• Assist in navigation of payer requirements and coordination with care teams.

Skills

Bilingual

Data entry

Customer service

Communication

Collaboration

Confidentiality

Education

High school diploma or GED

Associate’s Degree or higher preferred

Tools

Epic

Microsoft Excel

Outlook

Job description

Boston Medical Center is seeking a Prior Authorization Specialist I to join the Insurance Verification team in a remote, part-time capacity. The role focuses on screening prior authorizations, coordinating referrals, and ensuring timely financial clearance for inpatient, outpatient, and ancillary services.

The successful candidate will verify eligibility, navigate payer requirements, and support clinicians to maximize hospital reimbursement while maintaining high accuracy.