Remote Prior Authorization Specialist

Mass General Brigham; Somerville (MA); Remote; USD 25,000 - 39,000; Full time

Job summary

Mass General Brigham in Somerville, MA is seeking an Authorization Clerk to review and process prior authorization and referral requests for medical services, ensuring payer requirements and HIPAA compliance. You will gather documentation and enter outcomes in the electronic health record.

This regular, full-time role offers a day shift, 40 hours per week, remote work option, and collaboration with clinicians to submit proper CPT codes and resolve authorization issues efficiently.

Qualifications

• High school diploma or equivalent required.
• Epic experience preferred (0–1 year).
• Medical authorization or related field experience 1–2 years preferred.

Responsibilities

• Secure insurance authorizations in a timely manner.
• Submit proper CPT codes for prior authorization or referrals.
• Refer patients to financial counseling when appropriate.
• Inform patients of authorization concerns prior to admission, coordinating with appropriate parties.
• Update authorization status in the system and complete workflow.
• Respond to inquiries regarding authorization decisions.

Skills

Attention to detail

Communication

Medical terminology

DB familiarity

Teamwork

Fast-paced environment

Education

High School Diploma

Tools

Epic

Job description

Mass General Brigham in Somerville, MA is seeking an Authorization Clerk to review and process prior authorization and referral requests for medical services, ensuring payer requirements and HIPAA compliance. You will gather documentation and enter outcomes in the electronic health record.

This regular, full-time role offers a day shift, 40 hours per week, remote work option, and collaboration with clinicians to submit proper CPT codes and resolve authorization issues efficiently.