Remote Prior Authorization Specialist

Boston Medical Center; United States; Remote; USD 35,000 - 43,000; Full time

Job summary

Boston Medical Center is seeking a Remote Prior Authorization Specialist to support the Insurance Verification department. You will handle pre-registration tasks, verify insurance details, and obtain referrals and pre-certifications to ensure timely access to care and proper payer approvals.

Responsibilities include processing requests, confirming patient demographics, and coordinating with clinicians and billing staff to maintain compliance and efficient workflows across the organization.

Qualifications

• High school diploma or GED required.
• Experience with insurance verification and prior authorization processes preferred.
• Strong attention to detail and ability to handle high-volume requests.

Responsibilities

• Prioritize and process prior authorization requests.
• Verify member eligibility and complete required documentation in CCMS or Facets.
• Escalate complex cases to clinicians or managers as needed.
• Communicate decisions to providers and patients per policy.
• Collaborate with departments to ensure timely financial clearance for scheduled services.

Skills

Prior authorization

Insurance verification

Customer service

Epic experience

Education

High school diploma or GED

Associate’s degree or higher

Tools

Epic EHR

Job description

Boston Medical Center is seeking a Remote Prior Authorization Specialist to support the Insurance Verification department. You will handle pre-registration tasks, verify insurance details, and obtain referrals and pre-certifications to ensure timely access to care and proper payer approvals.

Responsibilities include processing requests, confirming patient demographics, and coordinating with clinicians and billing staff to maintain compliance and efficient workflows across the organization.