Remote Prior Authorization Specialist - Patient Access

bmc; United States; Remote; USD 52,000 - 76,000; Full time

Job summary

Boston Medical Center is seeking a Remote Prior Authorization Specialist I for the Patient Access Services team. The role coordinates financial clearance activities, including pre-registration, demographic and insurance validation, and obtaining referrals or precertifications to facilitate timely access to care.

You will collaborate with insurance companies, patients, physicians, and care teams to manage authorizations, verify eligibility, and ensure accurate documentation in Epic and other

Responsibilities

• Prioritize incoming Prior Authorization requests.
• Process requests and authorize services per policy.
• Refer complex cases to Prior Authorization Clinician, Manager, or Medical Director.
• Verify member eligibility and document in CCMS/Facets.
• Coordinate information with providers, payers, and patients.
• Assist with financial clearance and adherence to turnaround times.
• Educate patients and families about authorization requirements.
• Escalate denials per department policy.

Job description

Boston Medical Center is seeking a Remote Prior Authorization Specialist I for the Patient Access Services team. The role coordinates financial clearance activities, including pre-registration, demographic and insurance validation, and obtaining referrals or precertifications to facilitate timely access to care.

You will collaborate with insurance companies, patients, physicians, and care teams to manage authorizations, verify eligibility, and ensure accurate documentation in Epic and other