Remote Prior Authorization Specialist

Boston Medical Center (BMC); United States; Remote; USD 36,000 - 43,000; Part time

Job summary

Boston Medical Center seeks a Part Time Prior Authorization Specialist I to manage pre-authorization workflows, eligibility verification, and referrals. This remote role collaborates with providers, case management, and patient financial counselors to ensure timely access to care while maximizing reimbursement.

You will handle authorization requests, coordinate with clinicians, and navigate payer requirements within Epic systems, supporting efficient financial clearance for scheduled services.

Qualifications

• High school diploma or GED required.
• Associate degree or higher preferred.
• Experience with insurance verification and prior authorization is required.

Responsibilities

• Prioritize and process incoming Prior Authorization requests.
• Authorize services per departmental policies and workflows.
• Refer complex requests to clinicians or supervisors.
• Meet or exceed turnaround time goals with a full caseload.
• Answer calls, verify member eligibility, and enter data into CCMS or Facets.

Skills

Bilingual preferred

Strong oral and written communication

Multi-tasking and prioritization

Self-directed and highly organized

Confidentiality and HIPAA awareness

Education

High school diploma or GED

Associate’s Degree or higher preferred

Tools

Epic

ADt/Prelude/Grand Centrale

Microsoft Excel

Microsoft Word

Outlook

Zoom

Job description

Boston Medical Center seeks a Part Time Prior Authorization Specialist I to manage pre-authorization workflows, eligibility verification, and referrals. This remote role collaborates with providers, case management, and patient financial counselors to ensure timely access to care while maximizing reimbursement.

You will handle authorization requests, coordinate with clinicians, and navigate payer requirements within Epic systems, supporting efficient financial clearance for scheduled services.