Remote Prior Authorization Specialist I – Patient Access

Roslindale; Northern (KY); Hybrid; USD 72,839,000 - 88,742,000; Full time

Job summary

Boston Medical Center is seeking a dedicated Prior Authorization Specialist I to join the Revenue Cycle Patient Access team. The role focuses on financial clearance, including demographic validation, insurance verification, referrals, and precertifications to ensure timely access to care.

Applicants should have 4-5 years in a high-volume office or health care setting, strong communication skills, and the ability to navigate payer systems and Epic.

Qualifications

• High school diploma or GED required.
• Associate’s Degree or higher preferred.
• Experience with insurance verification, prior authorization, pre-certification and financial clearance.

Responsibilities

• Prioritize incoming prior authorization requests.
• Process authorization requests per policies and guidelines.
• Coordinate with clinicians or managers for cases needing judgement.
• Ensure accurate data entry of eligibility and referrals in systems.
• Escalate denied accounts per policy.

Skills

Bilingual

Communication skills

Attention to detail

Confidentiality

Multitasking

Education

High school diploma

Associate degree preferred

Tools

Epic

Excel

Word

Outlook

Zoom

Job description

Boston Medical Center is seeking a dedicated Prior Authorization Specialist I to join the Revenue Cycle Patient Access team. The role focuses on financial clearance, including demographic validation, insurance verification, referrals, and precertifications to ensure timely access to care.

Applicants should have 4-5 years in a high-volume office or health care setting, strong communication skills, and the ability to navigate payer systems and Epic.