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Insurance Prior Authorization Jobs in Boston, MA

Onco360

Pharmacy Prior Authorization Specialist

Waltham, MA · On-site +1

$22.25 - $29/hr

Company Paid Life Insurance; and Short/Long-Term Disability What You'll Do The Pharmacy Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations ...

Onco360

Pharmacy Prior Authorization Specialist

Waltham, MA · On-site

$22 - $28.50/hr

Company Paid Life Insurance; and Short/Long-Term Disability What You'll Do The Pharmacy Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations ...

inno

Authorization Representative

Medford, MA

$41K - $57K/yr

The role includes the following: insurance verifications, obtaining authorizations, and patient eligibility. RESPONSIBILITIES: * Obtain prior authorization or pre-certification of services to be ...

inno

Authorization Representative

Medford, MA

$41K - $57K/yr

The role includes the following: insurance verifications, obtaining authorizations, and patient eligibility. RESPONSIBILITIES: * Obtain prior authorization or pre-certification of services to be ...

inno

Authorization Commercial Team Lead

Medford, MA

Obtain and manage prior authorizations, pre-certifications, and insurance approvals in accordance with payer requirements. * Conduct insurance verification and re-verification to confirm eligibility ...

Innovive Health

Authorization Representative

Medford, MA · On-site

$20 - $23/hr

Re-verify patient eligibility, monitor insurance lifetime caps and prior authorization periods. * Resolve patient/payor issues in a timely manner. * Run various reports to keep up with patient ...

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All JobsInsurance Prior Authorization JobsInsurance Prior Authorization Jobs in Boston, MA

Insurance Prior Authorization information

See Boston, MA salary details

$27.7K

$71.3K

$90.7K

How much do insurance prior authorization jobs pay per year?

As of Jul 30, 2026, the average yearly pay for insurance prior authorization in Boston, MA is $71,324.00, according to ZipRecruiter salary data. Most workers in this role earn between $66,300.00 and $83,700.00 per year, depending on experience, location, and employer.

What is insurance prior authorization?

Insurance prior authorization is a process where healthcare providers must obtain approval from a patient's insurance company before performing certain medical procedures, prescribing medications, or providing specific services. This ensures that the recommended treatment is covered under the patient's insurance plan and is deemed medically necessary. The process may involve submitting clinical information and waiting for a decision from the insurance provider. Prior authorization is intended to control costs and ensure appropriate care, but it can sometimes delay access to treatment.

Is prior authorization a stressful job?

Insurance prior authorization is often considered a stressful role due to the need for accuracy, meeting strict deadlines, and handling complex cases. The job requires strong attention to detail, communication skills, and familiarity with insurance policies and medical documentation, which can contribute to work-related stress.

What are the key skills and qualifications needed to thrive in Insurance Prior Authorization, and why are they important?

To thrive in Insurance Prior Authorization, you need a solid understanding of medical terminology, insurance policies, and healthcare regulations, often supported by experience in a healthcare or insurance setting. Familiarity with electronic health record (EHR) systems, insurance portals, and authorization management software is typically required. Attention to detail, strong organizational skills, and effective communication are critical soft skills for managing complex cases and coordinating with providers and payers. These competencies ensure timely approvals, reduce claim denials, and improve patient access to necessary medical treatments.

How much do precertification specialists make?

Precertification specialists typically earn between $35,000 and $55,000 annually, depending on experience, location, and employer. They often require knowledge of insurance policies and may use claims processing software as part of their role.

What jobs pay 4000 a week without a degree?

Insurance prior authorization specialists typically do not earn $4,000 weekly without relevant experience or certifications. High-paying roles that can reach this level often include sales positions, real estate brokers, or skilled trades like certain construction or electrical work, which may require licenses but not necessarily a college degree. These jobs often demand strong skills, experience, or licensing rather than formal education.

How to become a prior authorization specialist?

To become a prior authorization specialist, candidates typically need a high school diploma or equivalent, along with knowledge of insurance policies and medical terminology. Relevant skills include attention to detail, communication, and familiarity with electronic health record (EHR) systems. Certification in medical billing or coding can enhance job prospects.

What are some common challenges faced in an Insurance Prior Authorization role, and how can they be effectively managed?

One of the main challenges in Insurance Prior Authorization is navigating the varying requirements and documentation standards of different insurance providers. This often requires staying updated on policy changes and maintaining close attention to detail to prevent delays or denials. Effective communication with healthcare providers and insurance representatives is also essential, as misunderstandings or incomplete information can slow down the process. Building strong organizational skills and using robust tracking systems can help manage workloads and ensure timely approvals, ultimately supporting patient care.

What is the difference between Insurance Prior Authorization vs Insurance Claims Specialist?

AspectInsurance Prior AuthorizationInsurance Claims Specialist
Required CredentialsKnowledge of insurance policies, healthcare regulationsUnderstanding of claims processing, coding, documentation
Work EnvironmentHealthcare providers, insurance companies, hospitalsInsurance companies, healthcare organizations, billing departments
Employer & Industry UsageUsed to approve coverage before services are renderedHandles post-service claims, reimbursement processing
Search & Comparison IntentUnderstanding pre-authorization processClaims processing and reimbursement procedures

Insurance Prior Authorization involves obtaining approval from insurance companies before healthcare services are provided, ensuring coverage. In contrast, Insurance Claims Specialists process claims after services are rendered to secure payment. Both roles require knowledge of insurance policies but focus on different stages of the insurance process.

Insurance Prior Authorization jobs near you
Infographic showing various Insurance Prior Authorization job openings in Boston, MA as of July 2026, with employment types broken down into 100% Full Time. Highlights an 89% In-person, and 11% Remote job distribution, with an average salary of $71,324 per year, or $34.3 per hour.

Prior Authorization Specialist

CareMed Specialty Pharmacy

Waltham, MA • On-site, Remote

$23 - $28/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 2 days ago

Job description

Pharmacy Prior Authorization Specialist – CareMed Specialty Pharmacy
Waltham, MA | Full-Time | Starting at $23.00/hr and up
Sign-On Bonus: $5,000 for employees starting before August 31, 2026!
Join a mission-driven team making a difference in the lives of cancer and rare disease patients.
CareMed Specialty Pharmacy is seeking a Pharmacy Prior Authorization Specialist to join our dedicated team in Waltham, MA. This is a full-time position ideal for candidates local to the area. Remote work possible after initial on-site training.
Company Benefits
  • Medical; Dental; Vision
  • 401k with a match
  • Paid Time Off and Paid Holidays
  • Tuition Reimbursement
  • Quarterly Incentive Bonus
  • Paid Volunteer Day
  • Referral Incentive Program
  • Company Paid Life Insurance; and Short/Long-Term Disability
Why Join Us?
  • A career with purpose: Help patients access life-saving medications.
  • Supportive culture: We value teamwork, respect, integrity, and passion.
  • Growth opportunities: We invest in your professional and personal development.
What You’ll Do
The Pharmacy Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations from insurance carriers by receiving prescriptions, addressing and rectifying rejected claims and conducting necessary third party authorization requests.
How You’ll Do This
  • Manage prior authorization requests and appeals with insurance carriers.
  • Collaborate with physicians, pharmacists, and other departments.
  • Ensure HIPAA compliance while handling sensitive patient information.
  • Maintain accurate documentation of authorization details.
  • Proactively monitor and renew expiring authorizations.
What You Bring
Required:
  • High School Diploma or GED
  • 1+ years of pharmacy or prior authorization experience
  • Registration with Board of Pharmacy (as required by state law)
  • Strong communication, organizational, and customer service skills
  • Self-motivated, organized, detail-oriented, and adaptable to changing priorities
  • Knowledge of pharmacy terminology, pharmacy insurance claims, Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, experience with CoverMyMeds
Preferred:
  • Associate degree or Certified Pharmacy Technician (PTCB)
  • 3+ years of experience in pharmacy or prior authorizations
  • Specialty pharmacy experience
Ready to make a meaningful impact? Apply today and help us better the lives of those battling cancer.

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