Top 347 Prior authorization remote Jobs in Boston Ma

Prior Authorization Specialist
Mass General Brigham Incorporated —Somerville, MA
- $28.30 an hour
- Full-time
- Remote
- HIPAA
- High school diploma or GED
- Organizational skills
- Opportunities for advancement
Quick Apply
5d
Team Lead, Prior Authorizations
Mass General Brigham Incorporated —Somerville, MA
- $25.50 - $36.49 an hour
- Full-time
- Remote
- HIPAA
- 3 years
- High school diploma or GED
- Opportunities for advancement
Quick Apply
5d
Authorization Specialist
New England Life Care —Canton, MA
- $21 - $22 an hour
- Full-time
- Microsoft Word
- Microsoft Excel
- Customer service
- Disability insurance
- Health insurance
Quick Apply
Clinical Policy Configuration Specialist
Cohere Health —Boston, MA
- $65,000 - $80,000 a year
- Remote
- Microsoft Word
- Nursing
- Microsoft Excel
- Paid parental leave
- Health savings account
Quick Apply
Patient Support Supervisor - Certified Pharmacy Technician, Prior Authorizations
Shields Health Solutions —Stoughton, MA
- Remote
- Microsoft Outlook
- Mid-level
- High school diploma or GED
- Paid time off
Quick Apply
Client Support Specialist
Cohere Health —Boston, MA
- $55,000 - $60,000 a year
- Remote
- Computer Science
- Mid-level
- Analysis skills
- Paid parental leave
- Health savings account
Quick Apply
3d
Patient Experience Representative (7:00am-3:30pm)
Boston Children's Hospital —Boston, MA
- $19.83 - $29.49 an hour
- Weekends as needed
- Administrative experience
- High school diploma or GED
- Bachelor's degree
2d
Medical Policy Writer
Cohere Health —Boston, MA
- $80,000 - $100,000 a year
- Remote
- Nursing
- Research
- Mid-level
- Paid parental leave
- Health savings account
Quick Apply
Member Services Associate
RapidRatings —Quincy, MA
- $55,000 a year
- Online Application
- Hybrid work
- English
- Mid-level
- Office
Quick Apply
RN Reviewer
Cohere Health —Boston, MA
- $33 - $35 an hour
- Weekends as needed
- Remote
- Google Workspace
- Nursing
- RN License
- Paid parental leave
- Health savings account
Quick Apply
Utilization Management Nurse, Out of Network
Mass General Brigham Health Plan Holding Company, Inc. —Somerville, MA
- $58,656.00 - $142,448.80 a year
- Full-time
- Remote
- Microsoft Word
- Nursing
- Microsoft Excel
- Health insurance
- Opportunities for advancement
Quick Apply
3d
Claims Review Specialist, DSNP
Mass General Brigham Health Plan Holding Company, Inc. —Somerville, MA
- $17.71 - $25.28 an hour
- Full-time
- Remote
- Research
- Mid-level
- High school diploma or GED
- Health insurance
- Opportunities for advancement
Quick Apply
2d
Compliance Reporting Program Manager
Cohere Health —Boston, MA
- $110,000 - $125,000 a year
- Remote
- 8 years
- SQL
- Analysis skills
- Paid parental leave
- Health savings account
Quick Apply
Clinical Audit Response Specialist
Dana-Farber Cancer Institute —Boston, MA
- $110,200 - $122,300 a year
- Full-time
- Nursing
- RN License
- 5 years
Patient Experience Representative (24 hours)
Boston Children's Hospital —Boston, MA
- $19.83 - $29.49 an hour
- Part-time
- Administrative experience
- High school diploma or GED
- Bachelor's degree
Procurement Specialist (Buyer)
Raytheon —Boston, MA
- $68,900 - $131,100 a year
- Full-time
- Remote
- Microsoft Excel
- Mid-level
- Analysis skills
- Paid holidays
- Disability insurance
1d
Sr BI Analyst
Citizens Financial Group —Westwood, MA
- $105,000 - $140,000 a year
- Full-time
- Background check
- Marketing
- 5 years
- Health insurance
- Dental insurance
Senior Clinical Informaticist
Cohere Health —Boston, MA
- $75,000 - $100,000 a year
- Nursing
- RN License
- Master's degree
- Paid parental leave
- Health savings account
Quick Apply
Expanded Practice Support Assistant
Optum —Quincy, MA
- $18 - $32 an hour
- Full-time
- Hybrid work
- Private practice
- Pass drug screening
- Mid-level
- AD&D insurance
- Employee stock purchase plan
Patient Experience Representative - Immunology Call Center
Boston Children's Hospital —Boston, MA
- $19.83 - $29.49 an hour
- Full-time
- Administrative experience
- High school diploma or GED
- Bachelor's degree

I want to receive the latest job alert for prior authorization remote in boston ma

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

prior authorization remote jobs near boston ma

Compliance Manager jobs in Boston, MA

Patient Representative jobs in Boston, MA

Call Center Representative jobs in Boston, MA

Client Services Specialist jobs in Boston, MA

Medical Writer jobs in Boston, MA

Clinical Specialist jobs in Boston, MA

Registered Nurse jobs in Boston, MA

Procurement Specialist jobs in Boston, MA

Member Services Representative jobs in Quincy, MA

Prior Authorization Remote jobs in South Carolina

Intake Specialist jobs in Greenville, SC

Prior Authorization Specialist jobs in Spokane, WA

Prior Authorization Specialist jobs in Aurora, IL

Prior Authorization Nurse jobs in Chicago, IL

Prior Authorization Specialist jobs in Pittsburgh, PA

Prior Authorization jobs in Maine

Prior Authorization Specialist jobs in Dover, DE

Customer Success Specialist jobs in Atlanta, GA

Injury Prevention Specialist jobs in Texas

Authorization Specialist jobs in Sacramento, CA

Prior Authorization Specialist

Mass General Brigham Incorporated -
Somerville, MA

Quick Apply

Job Details

Full-time
$28.30 an hour
5 days ago

Benefits

Opportunities for advancement

Qualifications

Customer inquiry handling
High school diploma or GED
Video conferences (communication methods)
Video conferencing systems operation

Full Job Description

Site: Mass General Brigham Incorporated

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

Summary

Reviews and processes prior authorization and referral requests for medical services in accordance with organizational policies and payer requirements. Ensures insurance eligibility, coordination of benefits, site‑of‑care compliance, and medical necessity by gathering and submitting complete medical documentation in alignment with HIPAA standards. Accurately documents authorization outcomes and all payer communications in the electronic health record.

Essential Functions

Work as part of a group to secure insurance authorizations in an appropriate timeframe. Collects and accurately enters information required by third parties for precertification for procedures, tests and imaging.

When unclear, collaborates with ordering clinicians to ensure the proper CPT codes are submitted for prior authorization or referrals.

Refer patients to financial counseling, as appropriate.

Inform patient of authorization concerns prior to admission/procedure, coordinating with appropriate parties to facilitate authorization as appropriate, collaborating with other departments/offices to resolve complex authorization issues.

Update authorization status in system and complete workflow.

Respond to internal and external inquiries regarding authorization decisions and provide explanations as needed.

Qualifications

Education

High School Diploma or Equivalent required

Experience

Medical authorization or related field experience 1-2 years preferred
Epic experience 0-1 year preferred

Knowledge, Skills and Abilities

- Excellent attention to detail and organizational skills.
- Strong communication and interpersonal skills.
- Knowledge of medical terminology and medical insurance benefits, including a complete understanding of the coordination of benefits.
- Familiarity with computer systems and databases.
- Ability to work independently and as part of a team.
- Ability to work in a fast-paced environment.

Additional Job Details (if applicable)

Remote Model Requirements

Remote
M-F Eastern business hours required
Employees must use a stable, secure, and compliant workstation in a quiet environment. Teams video is required and must be accessed using MGB-provided equipment.

Remote Type

Remote

Work Location

399 Revolution Drive

Scheduled Weekly Hours

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$ - $28.30/Hourly

Grade

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

EEO Statement:

0100 Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

Quick Apply

Refine Your Search

prior authorization remote jobs in boston ma

Prior Authorization Specialist

Team Lead, Prior Authorizations

Authorization Specialist

Clinical Policy Configuration Specialist

Patient Support Supervisor - Certified Pharmacy Technician, Prior Authorizations

Client Support Specialist

Patient Experience Representative (7:00am-3:30pm)

Medical Policy Writer

Member Services Associate

RN Reviewer

Utilization Management Nurse, Out of Network

Claims Review Specialist, DSNP

Compliance Reporting Program Manager

Clinical Audit Response Specialist

Patient Experience Representative (24 hours)

Procurement Specialist (Buyer)

Sr BI Analyst

Senior Clinical Informaticist

Expanded Practice Support Assistant

Patient Experience Representative - Immunology Call Center

I want to receive the latest job alert for prior authorization remote in boston ma

Related Searches

Explore jobs in more locations

Mass General Brigham Competency Framework

Job Seeker Tools

Employer Tools

Browse

Stay Connected