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Insurance Prior Authorization Jobs in Boston, MA

New England Life Care

Authorization Specialist

Woburn, MA · On-site

$19.75 - $26.25/hr

The Remote Authorization Specialist is responsible for obtaining and maintaining prior ... Life insurance, Short- and long-term disability insurance * Paid time off * And much more!

Vitra Health

Care Access Navigator

Boston, MA · On-site

$26 - $28/hr

The Opportunity The Care Access Navigator is a brand ambassador responsible for preparing and obtaining documentation needed for insurance prior authorization, continuity of care, and maintaining our ...

VITRA Health

Care Access Navigator

Boston, MA

$26 - $28/hr

The Opportunity The Care Access Navigator is a brand ambassador responsible for preparing and obtaining documentation needed for insurance prior authorization, continuity of care, and maintaining our ...

Vitra Health

Care Access Navigator

Boston, MA · On-site

$26 - $28/hr

The Opportunity The Care Access Navigator is a brand ambassador responsible for preparing and obtaining documentation needed for insurance prior authorization, continuity of care, and maintaining our ...

US Tech Solutions

Utilization Review Nurse

Canton, MA · On-site

$55 - $60/hr

Previous Managed Care, Health Plan, Medicare, Medicaid, or Commercial Insurance experience. * Strong knowledge of: * Utilization Management (UM) * Medical Necessity Review * Prior Authorization

HealthQ

Medical Billing Assistant

Beverly, MA · On-site

$18.50 - $23/hr

The Medical Billing Assistant supports front-end revenue cycle operations for the health center, ensuring accurate insurance verification, prior authorization, charge review, and claim submission.

HealthQ

Medical Billing Assistant

Beverly, MA · On-site

$18.50 - $23/hr

The Medical Billing Assistant supports front-end revenue cycle operations for the health center, ensuring accurate insurance verification, prior authorization, charge review, and claim submission.

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Showing results 21-40

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 Aug 20, 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.

What are the key skills and qualifications needed to thrive in insurance prior authorization?

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.

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.

Are insurance prior authorization jobs in high demand?

Insurance prior authorization jobs are in steady demand due to the ongoing need for healthcare cost management and insurance processing. These roles often require strong organizational skills and familiarity with insurance policies and medical billing systems, making them a stable career option in the healthcare administration field.

How to become an insurance prior authorization specialist?

To become an insurance prior authorization specialist, candidates typically need a high school diploma or equivalent, along with experience in healthcare or insurance billing. Relevant skills include knowledge of insurance policies, medical terminology, and proficiency with electronic health record (EHR) systems; certifications such as the Certified Professional Coder (CPC) can enhance job prospects.

Is insurance prior authorization a stressful job?

Insurance prior authorization is often considered a stressful job due to the need for accuracy, attention to detail, and managing multiple cases under tight deadlines. Employees frequently handle complex documentation and communicate with healthcare providers and insurance companies, which can contribute to work-related stress. Strong organizational skills and familiarity with insurance policies can help mitigate some of these challenges.
Insurance Prior Authorization jobs near you
Infographic showing various Insurance Prior Authorization job openings in Boston, MA as of August 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.

Authorization Specialist

New England Life Care

Woburn, MA • On-site

$19.75 - $26.25/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 6 days ago

New England Life Care rating

6.3

Company rating: 6.3 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

Job description

New England Life Care (NELC) is one of the fastest growing home infusion therapy companies in New England and is the region's only non-profit home infusion provider. NELC is a hospital collaborative serving more than 70 hospital systems in Maine, New Hampshire, and Massachusetts. NELC was created by local hospitals to ensure their patients have access to a provider that reflects their commitment to excellence in patient care, quality, and service. Like our owner hospitals, NELC provides patient focused care.
New England Life Care has and continues to build a diverse, inclusive, and authentic workplace, so if you're energized by this opportunity, but your experience doesn't support every qualification in the job posting, we encourage you to apply! You still may be the person we are looking for!
New England Life Care currently has a Remote Authorization Specialist position available. The normal schedule is Monday - Friday from 8:30am to 5:00pm.
The ideal candidate for this role will have at least three years of authorization or billing experience.
**Only hiring for this remote role in the following states:Maine, Massachusetts, New Hampshire, Maryland, North Carolina, Connecticut, and Florida**
Job Summary:
The Remote Authorization Specialist is responsible for obtaining and maintaining prior authorization status for NELC patient medications/therapies. The authorization specialist works closely with the clinical review department to obtain documentation needed to complete the authorization process. The authorization specialist also obtains needed documentation to support the billing department in meeting payer requirements for patient accounts.
Career Ladders: NELC's reimbursement department offers career ladders to Authorization Specialists. Candidates who achieve excellent performance in their job duties, who demonstrate a commitment to personal development, participation in department and company strategic programs and projects, who develop superior working relationships inside and outside the department and who show a commitment to the success of the department are eligible for promotion to the following positions:
Authorization Specialist- represents an entry level position into the department. Candidates who meet defined goals, objectives and accomplishments can generally expect to be promoted in 2-3 years to:
Senior Authorization Specialist - Candidates who meet defined goals, objectives, and accomplishments and who demonstrate engagement and ownership of departmental and organization activities would generally expect to be promoted in 4-5 years to:
Lead Authorization Specialist - Candidates who are part of the department leadership team and who have responsibility for advanced departmental, company and member hospital engagement.
Benefits:

  • Remote position
  • Room for growth and potential for advancement
  • Health insurance
  • Dental insurance
  • Vision insurance
  • Generous employer-matched 403b savings program
  • Company paid: Life insurance, Short- and long-term disability insurance
  • Paid time off
  • And much more!
Responsibilities:
  • Achieve performance appraisals with "meets expectations" or better
  • Maintain a good record of attendance and punctuality
  • No Performance management deficiencies in the period
  • Demonstrate independence and competence to follow Authorization Request process for all payers.
  • Demonstrate independence and competence to follow the Re-Authorization process
  • Demonstrate independence and competence to follow the Specialty process
  • Demonstrate independence and competence on all MOA's and therapies
  • Demonstrate independence and competence and ability to Authorize all services, document and communicate accurately on all changes of service, in CPR+ and to appropriate departments.
  • Demonstrate independence and competence and ability to work through a TO DO without the need for extended timeframes.
  • Demonstrates the ability to work within a team and independently with confident communication skills and exceptional customer service skills.
  • Completes three continuing education programs in the period specifically related to professional development, LEAN and/or leadership development.
Education:
  • High School Diploma, or equivalent required.
  • Minimum of 2 years authorization, reimbursement or claims processing experience required.
  • Practical experience with medical terminology; CPT, ICD-9 and HCPC coding preferred.
  • Practical experience with Medicare, Medicaid and third-party payor contracts preferred
  • Knowledge of HIPAA Privacy and Security requirements preferred.
Skills:
  • Excellent organizational skills required.
  • Basic accounting transaction/analyst skills required.
  • Demonstrated ability to identify research and solve problems required.
  • Ability to work independently as well as part of a team required.
  • Practical experience with Microsoft computer systems and applications, to include Word & Excel

''It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment.
An employer who violates this law shall be subject to criminal penalties and civil liability.''
EOE
The normal schedule is Monday - Friday from 8:30am to 5:00pm.

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