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Remote Prior Authorization Jobs in Massachusetts

Pharmacy Prior Authorization Specialist

Waltham, MA ยท On-site +1

$22.25 - $29/hr

Remote work possible after initial on-site training. Why Join Us? * A career with purpose: Help ... Manage prior authorization requests and appeals with insurance carriers. * Collaborate with ...

$135K - $161K/yr

The Drug Authorization Specialist, with direct supervision of the Prior Authorization Supervisor, is responsible for managing all work related to drug authorizations for all injectable drug treatment ...

$45K - $48K/yr

The Drug Authorization Specialist, with direct supervision of the Prior Authorization Supervisor, is responsible for managing all work related to drug authorizations for all injectable drug treatment ...

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Remote Prior Authorization information

See Massachusetts salary details

$14

$22

$35

How much do remote prior authorization jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for remote prior authorization in Massachusetts is $22.82, according to ZipRecruiter salary data. Most workers in this role earn between $18.89 and $25.19 per hour, depending on experience, location, and employer.

What is a remote prior authorization job?

Remote prior authorization jobs involve reviewing and processing requests from healthcare providers to determine if specific medical treatments, medications, or procedures are covered by a patient's insurance plan. Employees in these roles work from home, utilizing online systems to evaluate clinical information, communicate with providers, and ensure compliance with insurance policies. This position requires a strong understanding of medical terminology, insurance guidelines, and attention to detail to facilitate timely and accurate approvals or denials. Remote prior authorization specialists help streamline patient care by acting as a liaison between healthcare providers and insurance companies.

What is a remote prior authorization job?

Remote prior authorization jobs focus on working with insurance companies to coordinate benefit coverage and get approval to provide care for a patient. In this pre-authorization role, you may collect documentation and proof of insurance, perform data entry, help evaluate the need for a particular process, and otherwise work from home to help manage the prior authorization process. Remote prior authorization personnel often answer telephone calls to provide consultations, perform initial benefit verification, document case status, actions, and outcomes in a database, and use customer service skills to help expedite cases as needed. Since this is a remote call center-style job, you may be asked to arrange for a quiet office in your house that is free of distractions.

What are the key skills and qualifications needed to thrive as a remote prior authorization specialist, and why are they important?

To thrive as a Remote Prior Authorization Specialist, you need a solid understanding of medical terminology, insurance processes, and healthcare regulations, often supported by experience in medical billing or coding. Familiarity with electronic health record (EHR) systems, insurance portals, and prior authorization software is typically required. Attention to detail, strong organizational skills, and effective communication are crucial soft skills in this role. These skills ensure timely and accurate processing of authorizations, reducing claim denials and supporting efficient patient care.

What are some common challenges faced by remote prior authorization specialists, and how can they be addressed?

Remote Prior Authorization specialists often encounter challenges such as navigating complex insurance requirements, managing high volumes of requests, and maintaining clear communication with healthcare providers and payers. Staying organized and up-to-date on payer policies is crucial, as requirements can vary widely between insurers. Utilizing workflow management tools and fostering strong collaboration with clinical and administrative teams can help streamline processes and reduce delays, ultimately ensuring patients receive timely care.

What is the difference between Remote Prior Authorization vs Remote Medical Coder?

AspectRemote Prior AuthorizationRemote Medical Coder
Required CredentialsMedical credentials, insurance knowledgeMedical coding certification (CPC, CCS)
Work EnvironmentHealthcare offices, insurance companies, remoteHealthcare facilities, remote coding jobs
Industry UsageInsurance, healthcare providersHospitals, clinics, billing companies
Job FocusReviewing and approving insurance requestsTranslating medical records into codes

Remote Prior Authorization and Remote Medical Coder roles both operate within the healthcare industry but focus on different tasks. Remote Prior Authorization involves reviewing insurance requests for coverage approval, requiring insurance and medical knowledge. Remote Medical Coders translate medical records into standardized codes, primarily focusing on billing and documentation. Both roles can be performed remotely and require healthcare-related credentials, but their daily responsibilities and skill sets differ significantly.

Are remote prior authorization jobs in high demand?

Remote prior authorization jobs are in moderate to high demand due to the increasing need for efficient healthcare administration and insurance processing. These roles often require knowledge of healthcare policies, strong communication skills, and familiarity with electronic health record systems. The demand is expected to grow as healthcare providers and insurers continue to prioritize remote and streamlined authorization processes.

What are the most commonly searched types of Prior Authorization jobs in Massachusetts?

The most popular types of Prior Authorization jobs in Massachusetts are:

What job categories do people searching Remote Prior Authorization jobs in Massachusetts look for?

The top searched job categories for Remote Prior Authorization jobs in Massachusetts are:

What cities in Massachusetts are hiring for Remote Prior Authorization jobs?

Cities in Massachusetts with the most Remote Prior Authorization job openings:

Infographic showing various Remote Prior Authorization job openings in Massachusetts as of August 2026, with employment types broken down into 67% Full Time, and 33% Part Time. Highlights an 100% Remote job distribution, with an average salary of $47,463 per year, or $22.8 per hour.

Prior Authorization Specialist

Massgeneralbrigham

Somerville, MA โ€ข Remote

$28.30/hr

Full-time

Medical

Posted 4 days ago


Job description

Site: Mass General Brigham Incorporated


Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.


Job Summary

Summary
Reviews and processes prior authorization and referral requests for medical services in accordance with organizational policies and payer requirements. Ensures insurance eligibility, coordination of benefits, siteofcare compliance, and medical necessity by gathering and submitting complete medical documentation in alignment with HIPAA standards. Accurately documents authorization outcomes and all payer communications in the electronic health record.
Essential Functions
-Work as part of a group to secure insurance authorizations in an appropriate timeframe. Collects and accurately enters information required by third parties for precertification for procedures, tests and imaging.
-When unclear, collaborates with ordering clinicians to ensure the proper CPT codes are submitted for prior authorization or referrals.
-Refer patients to financial counseling, as appropriate.
-Inform patient of authorization concerns prior to admission/procedure, coordinating with appropriate parties to facilitate authorization as appropriate, collaborating with other departments/offices to resolve complex authorization issues.
-Update authorization status in system and complete workflow.
-Respond to internal and external inquiries regarding authorization decisions and provide explanations as needed.


Qualifications

Education

  • High School Diploma or Equivalent required


Experience

  • Medical authorization or related field experience 1-2 years preferred
  • Epic experience 0-1 year preferred


Knowledge, Skills and Abilities

  • - Excellent attention to detail and organizational skills.
  • - Strong communication and interpersonal skills.
  • - Knowledge of medical terminology and medical insurance benefits, including a complete understanding of the coordination of benefits.
  • - Familiarity with computer systems and databases.
  • - Ability to work independently and as part of a team.
  • - Ability to work in a fast-paced environment.

Additional Job Details (if applicable)

Remote Model Requirements

  • Remote
  • M-F Eastern business hours required
  • Employees must use a stable, secure, and compliant workstation in a quiet environment. Teams video is required and must be accessed using MGB-provided equipment.


Remote Type

Remote


Work Location

399 Revolution Drive


Scheduled Weekly Hours

40


Employee Type

Regular


Work Shift

Day (United States of America)


Pay Range

$ - $28.30/Hourly

Grade

3


At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.


EEO Statement:

0100 Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.


Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.