Remote Prior Authorization Specialist I (Patient Access)

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

Job summary

Boston Medical Center is seeking a Prior Authorization Specialist I to support the Patient Access Services team from a remote location. The role coordinates financial clearance, verifies demographics and insurance, and secures referrals and pre-certifications to ensure access and maximize hospital reimbursement.

The position requires 4–5 years of relevant office experience, familiarity with Epic workflows, and strong communication with diverse stakeholders. High school diploma or GED is required.

Qualifications

• High school diploma or GED required.
• Associate’s Degree or higher preferred.
• 4-5 years of office experience in a high-volume or healthcare setting are required.
• Experience with insurance verification, prior authorization, pre-certification and financial clearance processes is preferred.

Responsibilities

• Prioritize and process prior authorization requests.
• Verify member eligibility and enter information into CCMS or Facets.
• Coordinate referrals and pre-certifications for scheduled services.
• Collaborate with providers, payers and care teams to obtain approvals.
• Maintain confidentiality and adhere to privacy and regulatory policies.
• Provide timely, accurate data entry and documentation in Epic and related systems.

Skills

Bilingual

High-volume processing

Prioritization

Collaboration

Communication

Attention to detail

Confidentiality

Epic knowledge

MS Office

Decision making under pressure

Education

High school diploma or GED

Associate's degree or higher preferred

Tools

Epic

Microsoft Excel

Job description

Boston Medical Center is seeking a Prior Authorization Specialist I to support the Patient Access Services team from a remote location. The role coordinates financial clearance, verifies demographics and insurance, and secures referrals and pre-certifications to ensure access and maximize hospital reimbursement.

The position requires 4–5 years of relevant office experience, familiarity with Epic workflows, and strong communication with diverse stakeholders. High school diploma or GED is required.