Prior Authorization Specialist (Remote) in Boston, Massachusetts - #72552 | VanderHouwen

Description

Job Id: 72552

Prior Authorization Specialist (Remote)
Our client is seeking a detail-oriented and customer-focused Prior Authorization Specialist to support healthcare authorization operations in a fast-paced remote environment. This individual will play a key role in ensuring timely and accurate processing of service requests while collaborating with providers, clinical teams, and internal stakeholders. The ideal candidate is highly organized, thrives in a high-volume setting, and is committed to delivering exceptional service and operational excellence.

This role is fully remote.

Prior Authorization Specialist Responsibilities

• Review, prioritize, and process prior authorization requests for a variety of healthcare services in accordance with established guidelines and turnaround standards.
• Gather and verify required documentation, communicate with providers regarding missing information, and route complex cases for clinical review when appropriate.
• Respond to provider and member inquiries, verify eligibility and benefits, and assist with navigating authorization requirements and processes.
• Maintain accurate records and documentation within healthcare systems while meeting productivity, quality, and accuracy goals.
• Collaborate with clinical teams and cross-functional departments to resolve escalated issues and support efficient authorization workflows.

Prior Authorization Specialist Qualifications

• Associate degree in Healthcare, Social Work, Business, or a related field, or an equivalent combination of education and experience.
• Three or more years of experience in healthcare administration, medical office operations, utilization management support, or a related healthcare environment.
• Experience working with healthcare databases, authorization platforms, or electronic health systems preferred.
• Strong customer service, communication, and problem-solving skills with the ability to interact professionally with providers, members, and internal teams.
• Proven ability to manage competing priorities, maintain a high level of accuracy, and work effectively in a high-volume remote setting utilizing Microsoft Office applications.

Compensation: (DOE)

VanderHouwen Contractors Enjoy Exceptional Benefit Perks!
As an eligible contract employee with VanderHouwen, you'll have access to a full suite of benefits designed with your well-being in mind. Our comprehensive package includes medical, dental, vision, life insurance, short- and long-term disability, and a matching 401(k) to help secure your future.

Meet VanderHouwen
What kind of recruiter do you see yourself working with? One who prioritizes your best interest, no matter what? VanderHouwen does, and we're in it for the long game! Our recruiters focus on YOU, building meaningful, long-term relationships while developing a deep understanding of companies' staffing needs and workplace cultures. This approach helps us find an ideal job match that aligns with your unique career aspirations and goals.

VanderHouwen is an award-winning, Women & Diversity-Owned, WBENC certified professional staffing firm. Founded in 1987, VanderHouwen places experienced professionals across the nation! Our recruitment teams specialize in either Technology and IT, Engineering, Human Resources, or Accounting and Finance career markets. Partner with us to land your next exciting career!

VanderHouwen is an Equal Opportunity Employer and participates in E-Verify. VanderHouwen does not discriminate based on race, color, religion, sex, national origin, age, disability, or any other characteristic protected by applicable local, state, or federal civil rights laws.

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