Remote Prior Authorization Specialist I – Patient Access

BMC Software; United States; Remote; USD 35,000 - 43,000; Full time

Job summary

Boston Medical Center seeks a Prior Authorization Specialist I for its Patient Access Services team. This remote role coordinates financial clearance, pre-registration, insurance verification, referrals, and pre-certifications to ensure timely access to care and proper reimbursement.

The position reports to the Patient Access Supervisor and collaborates with insurance companies, physicians, and care teams. The Specialist will document all steps in the Epic environment, adhere to guidelines, and

Qualifications

• High school diploma or GED required.
• 4-5 years of office experience in a high-volume setting or healthcare environment is required.
• Experience with insurance verification, prior authorization, and financial clearance processes.

Responsibilities

• Prioritize incoming Prior Authorization requests.
• Process requests including authorizing services per policies and workflows.
• Refer to clinicians for cases requiring medical judgment.
• Meet productivity and quality targets with a full caseload.
• Coordinate with patients, providers, and departments to obtain required information.

Skills

Bilingual

Interpersonal skills

Oral & written communication

Collaboration

Multitasking

Education

High school diploma or GED

Associate's degree or higher preferred

Tools

Epic systems

ADT/Prelude/Grand Centrale

CCMS/FACETS

Excel

Zoom

Job description

Boston Medical Center seeks a Prior Authorization Specialist I for its Patient Access Services team. This remote role coordinates financial clearance, pre-registration, insurance verification, referrals, and pre-certifications to ensure timely access to care and proper reimbursement.

The position reports to the Patient Access Supervisor and collaborates with insurance companies, physicians, and care teams. The Specialist will document all steps in the Epic environment, adhere to guidelines, and