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Evening Remote Prior Authorization Jobs in Ohio (NOW HIRING)

Legion Health

$50K - $150K/yr

... verification, billing, prior authorizations, pharmacy coordination, etc. * Commitment to ... Fully remote within the United States. * Schedule: Part-time * Compensation: $50K-150K per year ...

Valeris

Executive Case Manager (Remote)

Cincinnati, OH · Remote

This includes completing benefit investigations, tracking prior authorizations / denial appeals ... Remote work eligibility is subject to all work from home criteria met and based on business need ...

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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 Ohio?

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

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

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

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

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

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

Cities in Ohio 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 Ohio as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 16% Part Time, 2% Temporary, and 4% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution.

Pharmacy Prior Authorization Specialist

Communicarehealth

Broadview Heights, OH • Remote

$17.50 - $23.25/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 23 days ago

Communicare Health Services rating

6.1

Company rating: 6.1 out of 10

Based on 158 frontline employees who took The Breakroom Quiz

725th of 898 rated healthcare providers

Job description

Job Address:

9299 Market Place Broadview Heights, OH 44147


Job Description: Prior Authorization Specialist

Reports to: Pharmacy Prior Authorization Manager

Job Type: Full-Time - Remote - Pharmacies: West Virginia, Ohio, Indiana and Maryland

Position Overview: The Prior Authorization Specialist will maintain the Prior Authorization's workflow for a set of facilities assigned by the supervisor, while providing customer service to clients. He/she wil enter required information and submit Prior Authorizations to the respective plan, follow the prior authorization to completion, identify and clarify any discrepancies with a prior authorization, and participate in the appeal process.

Key Responsibilities Include but are not limited to:

  • Work in cohesion with the Adjudication, Claim Intervention and Billing Departments
  • Submit prior authorizations in accordance with Insurance regulations
  • Ensure accurate and timely processing of prior authorizations
  • Work directly with insurance companies for prior authorization resolution
  • Communicate with facilities to gain additional information
  • Any other duties assigned
  • Follow federal and state regulations
  • Adhere to company policies and procedures
  • Follow HIPPA guidelines and regulations

Qualifications and Requirements:

  • Prior Authorization experience (not required)
  • Previous Long-Term Care pharmacy experience a plus (not required)
  • Knowledge of Framework LTC a plus (not required)

Salary and Benefits:

  • Competitive salary commensurate with experience
  • Comprehensive benefits package, including health, dental, and vision insurance, 401(k) with company match, paid time off, and more

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