Remote Prior Authorization Specialist

Mass General Brigham Incorporated; Somerville (MA); On-site; USD 23,000 - 39,000; Full time

Job summary

Mass General Brigham Incorporated is seeking a Prior Authorization Specialist to process and coordinate medical service authorizations from initiation to final decision. The role requires attention to detail, strong communication, and knowledge of medical terminology and payer processes.

You will gather documentation, confirm eligibility, collaborate with clinicians for accurate CPT coding, and maintain timely status updates within the EHR.

Qualifications

• High School Diploma or equivalent required.
• Experience in medical authorization or related field preferred.
• Epic experience preferred.
• Strong attention to detail and organization.

Responsibilities

• Process prior authorization and referrals for medical services.
• Ensure insurance eligibility and coordination of benefits.
• Document authorization outcomes and payer communications in the EHR.
• Collaborate with ordering clinicians to ensure proper CPT codes are submitted.
• Inform patients of authorization concerns prior to admission.
• Update authorization status and respond to inquiries.

Skills

Attention to detail

Communication

Medical terminology

Insurance benefits

Computer systems

Databases

Teamwork

Independence

Fast-paced

Education

High School Diploma or Equivalent

Tools

Epic

Job description

Mass General Brigham Incorporated is seeking a Prior Authorization Specialist to process and coordinate medical service authorizations from initiation to final decision. The role requires attention to detail, strong communication, and knowledge of medical terminology and payer processes.

You will gather documentation, confirm eligibility, collaborate with clinicians for accurate CPT coding, and maintain timely status updates within the EHR.