Remote Prior Authorization Specialist I – Clearance

Boston Medical Center; United States; Remote; USD 34,000 - 43,000; Full time

Benefits offered by this job

Medical

Dental

Vision

Pharmacy

Contract increases

Flexible Spending Accounts

403(b) savings matches

Earned time cash out

Paid time off

Career advancement opportunities

Wellbeing resources

Job summary

Boston Medical Center is seeking a Prior Authorization Specialist I to support multiple hospital sites. The role handles insurance verification, authorizations, and coordination of referrals within the Epic environment, ensuring timely access to care while maximizing reimbursement.

Requirements include a high school diploma or GED (associate degree preferred) and 4–5 years in a similar setting; bilingual skills are a plus.

Qualifications

• High school diploma or GED required; Associate degree preferred.
• 4–5 years in a high-volume office or health care setting.
• Experience with insurance verification and prior authorization.
• Knowledge of Epic, Meditech, CCMS or Facets is helpful.

Responsibilities

• Prioritize incoming prior-authorization requests.
• Verify member eligibility and insurance details.
• Coordinate referrals and pre-certifications per policy.
• Enter data in registration systems and payer portals.
• Communicate with providers, patients, and payers to obtain approvals.

Skills

Bilingual

High volume

Accuracy 95%+

Prior authorization

Education

High school diploma or GED

Associate’s degree preferred

Tools

Epic

Meditech

CCMS

Facets

Job description

Boston Medical Center is seeking a Prior Authorization Specialist I to support multiple hospital sites. The role handles insurance verification, authorizations, and coordination of referrals within the Epic environment, ensuring timely access to care while maximizing reimbursement.

Requirements include a high school diploma or GED (associate degree preferred) and 4–5 years in a similar setting; bilingual skills are a plus.