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Evening Remote Prior Authorization Jobs in California

talentpluto

Account Executive

San Francisco, CA · On-site +1

$220K - $300K/yr

Remote Industry: Health tech / AI Compensation: $110K-$150K base, $220K-$300K OTE About the Company Our partner is a seed-stage health-tech company using agentic AI to solve prior authorization for ...

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Evening Remote Prior Authorization information

What is an evening remote prior authorization specialist?

An Evening Remote Prior Authorization specialist is a healthcare professional who works outside traditional business hours to review and process prior authorization requests for medical procedures, medications, or services. They work remotely, usually from home, using electronic systems to communicate with healthcare providers, insurance companies, and patients. Their main responsibility is to ensure that the requested treatments meet the insurance provider's requirements for coverage before services are rendered. This role helps to expedite patient care and reduce delays in treatment by providing authorization decisions during evening hours.

What are the key skills and qualifications needed to thrive as an evening remote prior authorization specialist?

To thrive as an Evening Remote Prior Authorization Specialist, you need a strong understanding of healthcare insurance processes, medical terminology, and prior authorization protocols, usually backed by experience in medical billing or a related field. Familiarity with electronic health record (EHR) systems, payer portals, and insurance verification software is typically required. Excellent communication, attention to detail, and the ability to work independently during off-hours are vital soft skills in this role. These competencies ensure timely and accurate processing of authorizations, minimize claim denials, and support efficient patient care outside standard business hours.

What are the main challenges of working as an evening remote prior authorization specialist, and how can I prepare for them?

Working as an Evening Remote Prior Authorization specialist often involves handling urgent requests and communicating with healthcare providers outside of traditional business hours. This can mean managing a higher volume of time-sensitive cases and troubleshooting issues when fewer support staff are available. To prepare, it's helpful to be highly organized, comfortable with independent problem-solving, and proactive in seeking clarification from providers or supervisors as needed. Familiarity with electronic health record (EHR) systems and strong written communication skills are also valuable for effectively managing remote work and ensuring timely approvals.

What is the difference between Evening Remote Prior Authorization vs Evening Remote Medical Billing Specialist?

AspectEvening Remote Prior AuthorizationEvening Remote Medical Billing Specialist
CredentialsTypically requires healthcare-related certifications (e.g., CPC, CCA)Requires billing and coding certifications (e.g., CPC, CCS)
Work EnvironmentRemote, healthcare provider offices, insurance companiesRemote, healthcare clinics, billing companies
Industry UsageUsed in healthcare insurance and provider organizationsUsed in healthcare billing and revenue cycle management
Primary FocusSecuring prior authorization for treatments or proceduresProcessing and submitting medical claims for reimbursement

While both roles operate remotely within the healthcare industry, Evening Remote Prior Authorization focuses on obtaining approval for treatments, whereas Evening Remote Medical Billing Specialists handle claims processing. Understanding these differences helps job seekers identify the right position based on their skills and career goals.

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

The most popular types of Remote Prior Authorization jobs in California are:

What are popular job titles related to Evening Remote Prior Authorization jobs in California?

For Evening Remote Prior Authorization jobs in California, the most frequently searched job titles are:

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

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

What cities in California are hiring for Evening Remote Prior Authorization jobs?

Cities in California with the most Evening Remote Prior Authorization job openings:

Evening Remote Prior Authorization jobs near you
Infographic showing various Evening Remote Prior Authorization job openings in California as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 18% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution.

Medical Director job in San Diego CA

Inspire Healthcare

San Diego, CA • On-site, Remote

$250K - $350K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 20 days ago

Job description

We are seeking a Remote Medical Director for a non-clinical role focused on prior authorization and medical necessity reviews. No direct patient care is required. Candidates must reside in the San Diego area and be available for occasional on-site meetings and trainings.

Responsibilities
  • Review prior authorization requests and determine medical necessity using evidence-based clinical guidelines.
  • Approve, deny, modify, or redirect services as appropriate.
  • Collaborate with nurses, physicians, and care management teams to support high-quality, cost-effective care.
  • Participate in appeals, grievance reviews, retrospective claims reviews, and quality improvement initiatives.
  • Serve as a clinical resource to providers on utilization management and patient care issues.
Qualifications
  • MD or DO degree required.
  • Board Certification in Internal Medicine strongly preferred.
  • Minimum 5 years of clinical experience required.
  • 2+ years of managed care, health plan, or utilization management experience preferred.
  • Strong knowledge of prior authorization processes and medical necessity criteria.
  • Excellent communication, organizational, and decision-making skills.
  • Proficiency with Microsoft Office and remote work technology.
Compensation & Benefits
  • Salary: $250,000"$350,000 annually DOE.
  • Comprehensive benefits package including medical, dental, vision, 401(k), paid time off, life insurance, FSA, tuition reimbursement, CME/license reimbursement, and employee assistance programs.

This is an excellent opportunity to join one of Southern California's fastest-growing physician organizations in a leadership role that supports quality patient care while maintaining work-life balance.

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About Inspire Healthcare

Sourced by ZipRecruiter

Inspire Healthcare, based in Boynton Beach, FL, US, is a dynamic firm in the healthcare staffing industry. Established with the dedication to provide a quality recruitment service to the healthcare sector, it is dedicated to assisting healthcare providers with their staffing needs. Its official website, ihcrecruiting.com, presents a comprehensive portfolio of services that cater to diverse healthcare facilities and positions. Its mission is firmly rooted in delivering professional healthcare staffing services that fulfill clients' needs efficiently and effectively, while also creating prosperous opportunities for healthcare professionals. A notable achievement of the company is its breadth of service, extending its recruiting coverage all across the country.

Industry

Recruiting and staffing services

Company size

11 - 50 Employees

Headquarters location

Boynton Beach, FL, US

Social media

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