Remote Prior Authorization Specialist (Per Diem)

Baystatehealth; United States; Remote; USD 32,000 - 44,000; Part time

Benefits offered by this job

Health benefits

Tuition assistance

Career growth opportunities

Retirement plan

Job summary

Baystate Health is seeking a Per Diem Prior Authorization Specialist to support referrals and authorizations for specialty services and testing. This remote role within Massachusetts and Connecticut collaborates with providers, insurance companies, and patients to ensure timely access to care and accurate documentation.

The position emphasizes problem-solving, independence, and high-quality service while coordinating with clinicians and staff across Baystate Health.

Qualifications

• 1-3 years of medical insurance knowledge.
• Bilingual in English/Spanish preferred.
• Proficiency with Microsoft Office (Word & Excel).

Responsibilities

• Process referrals and prior authorizations for specialty services and testing.
• Collaborate with clinical teams, physician offices, agencies, and insurance companies to obtain information.
• Monitor denial and no-referral reports and process appeals for denied claims.
• Manage the Electronic Referral Tracking Report and prioritize requests by urgency.
• Provide guidance and answers on referral/authorization questions to internal and external customers.
• Communicate authorization decisions to referring and ordering providers, staff, patients, and families.

Skills

Medical insurance knowledge

Bilingual English/Spanish

Microsoft Office (Word/Excel)

Education

GED or HiSET

Tools

CIS inbox

EMR

Job description

Baystate Health is seeking a Per Diem Prior Authorization Specialist to support referrals and authorizations for specialty services and testing. This remote role within Massachusetts and Connecticut collaborates with providers, insurance companies, and patients to ensure timely access to care and accurate documentation.

The position emphasizes problem-solving, independence, and high-quality service while coordinating with clinicians and staff across Baystate Health.