Prior Authorization Specialist - Remote

Overview

The Prior Authorization Specialist (PAS) plays a critical role in ensuring exceptional patient experiences by securing necessary authorizations for medical and surgical admissions, contributing significantly to the financial health of the organization.

In Short

• Facilitate patient experience by securing authorizations for services.
• Work across multiple hospital entities including BWH and BWFH.
• Maintain expert knowledge of insurance and managed care requirements.
• Interact with various healthcare professionals to gather necessary documentation.
• Monitor pending cases to ensure timely approvals.
• Advise patients on available programs for uninsured and underinsured.
• Utilize EPIC Clinical System for data entry and management.
• Collaborate with Patient Financial Services for billing accuracy.
• Ensure compliance with hospital policies and regulations.
• Demonstrate excellent customer service and communication skills.

Requirements

• Bachelor’s degree preferred; high school diploma required.
• 2+ years’ experience in hospital settings or related fields.
• Knowledge of insurance authorization requirements.
• Familiarity with revenue cycle and billing processes.
• Proficient in oral and written communication.
• Ability to work independently and manage multiple tasks.
• Strong problem-solving and organizational skills.
• Commitment to maintaining patient confidentiality.
• Experience with EPIC or similar healthcare systems.
• Ability to handle sensitive communications with tact and respect.

Benefits

• Opportunity to work in a leading healthcare organization.
• Contribute to patient care and community service.
• Collaborative and supportive work environment.
• Ongoing training and professional development.
• Comprehensive benefits package.