Prior Authorization

Published June 7th, 2024

Temp: Start end of June thru August
Hours: Monday – Friday, 8:00am-4:30pm
Pay: $25-$28, flexible
Location: Training onsite in Boston, fully remote after training
Job Description


Responsible for obtaining appropriate insurance authorizations, referrals and payments for all patient visits and procedures as well as collection of patient service coinsurance, deductibles and self-pay revenue.  There is a high level of direct or phone patient/physician interface.

  • Verifying insurance eligibility, benefits and ensuring and/or reviewing referral reports to verify active referrals on file for each patient visit.
  • Completing and (upon physician approval) physician treatment plans in their entirety and accurately to insurance companies in order to obtain financial clearance.
  • Responsible for identifying and collecting payments for non-covered patient service revenue which includes but is not limited to past due balances, non-covered services; deductibles and coinsurance.  
  • Responsible for correct and accurate posting in the billing system of collected patient service revenue. 
  • Explaining insurance coverage to patients, advising patients; requires detailed knowledge of insurance requirements and close attention to patient scheduled appointments since each insurance company has different requirements.
  • Ensuring patients have signed self-pay waivers and contracts when appropriate, understand the refund process. 
  • Ensuring signed documents are scanned into the electronic filing system. 
  • Explaining fee structures to patients for various treatment options and all other special programs.
  • Responsible for the centralized surgical billing calendar. Obtaining prior authorization for all surgeries on the PO side, as well as obtaining any facility authorizations the insurance company will provide.
  • Responsible for handling all patients’ billing problems and inquiries, and working with and triaging to the Billing, Compliance and Education team to resolve problems.
  • Responsible for ensuring insurance referrals are received which may include working with the patient’s primary care physician or patient to obtain a referral, educating secretarial staff regarding which services are and are not covered by each insurance plan and which require a referral
  • Receives and expedites all incoming/outgoing telephone calls in a professional and courteous manner.   


  • Customer service experience, required
  • College degree, preferred – or years of equivalent experience will be considered
  • 1-3 years’ experience in health care setting and extensive knowledge of 3rd party payers and billing requirements, preferred


  • Excellent interpersonal skills
  • Excellent written and oral communication skills
  • Accuracy, with attention to detail
  • Math/Financial experience
  • Ability to work both independently and as part of a team
  • Computer skills, including word processing and data entry
  • Ability to work under pressure, multi-task and meet deadlines
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