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From Home Cigna Prior Authorization Jobs (NOW HIRING)

... home delivery of prescription drugs. The Prior Authorization specialist responsibilities includes: taking in-bound calls from providers, PBM, etc. providing phone assistance to all callers through ...

$16.75 - $22.25/hr

Prior Authorization Specialist We are seeking a detail-oriented and experienced Prior Authorization ... from any location, while maximizing their professional growth and earning potential. We are ...

Prior Authorization Specialist

Louisville, KY · On-site

$16.50 - $22/hr

The Prior Authorization Coordinator is responsible for striving to complete either approval for ... Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the ...

Prior Authorization Specialist

New York, NY · On-site

$19.75 - $26.25/hr

... home health and hospice. Prior authorization is one of the largest operational bottlenecks for ... Identify recurring failure points and determine whether issues stem from payer requirements ...

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From Home Cigna Prior Authorization information

What are the main challenges of working remotely as a Cigna Prior Authorization specialist, and how can they be managed?

Working from home as a Cigna Prior Authorization specialist often involves managing high call volumes, staying updated with changing insurance policies, and maintaining clear communication with healthcare providers. Balancing productivity and avoiding distractions can also be challenging in a remote setting. To succeed, it's important to establish a dedicated workspace, use digital tools to stay organized, and participate in regular team meetings to stay connected and informed.

What is a From Home Cigna Prior Authorization job?

A From Home Cigna Prior Authorization job typically involves working remotely to review and process prior authorization requests for medical procedures, medications, or services on behalf of Cigna, a major health insurance provider. Employees in this role evaluate clinical documentation to determine if requested services meet Cigna’s coverage criteria and guidelines. The job may require communication with healthcare providers, patients, and internal teams to gather necessary information and ensure timely processing. Strong attention to detail, knowledge of medical terminology, and familiarity with insurance processes are important for success in this position.

What is the difference between From Home Cigna Prior Authorization vs From Home Cigna Medical Reviewer?

AspectFrom Home Cigna Prior AuthorizationFrom Home Cigna Medical Reviewer
CredentialsLicenses or certifications in healthcare administration or related fieldsMedical degrees (MD, DO) and clinical certifications
Work EnvironmentRemote, administrative settingRemote, clinical review setting
Employer & IndustryCigna, health insurance industryCigna, health insurance industry
Primary RoleReviewing and approving prior authorization requestsConducting detailed medical reviews and making clinical decisions

While both roles are remote positions within Cigna, the Prior Authorization specialist focuses on processing authorization requests, whereas the Medical Reviewer performs in-depth clinical assessments to support approval decisions. Both roles require healthcare knowledge but differ in clinical involvement and responsibilities.

What are the key skills and qualifications needed to thrive as a Work From Home Cigna Prior Authorization Specialist, and why are they important?

To thrive as a Work From Home Cigna Prior Authorization Specialist, you need a solid understanding of medical terminology, insurance processes, and prior authorization procedures, often supported by healthcare-related experience or certification. Familiarity with insurance management systems, electronic health records (EHR), and specialized authorization software is typically required. Strong attention to detail, effective communication, and the ability to work independently are essential soft skills in this remote role. These competencies ensure accurate processing of authorization requests, compliance with guidelines, and high-quality service to patients and providers.
More about From Home Cigna Prior Authorization jobs
What cities are hiring for From Home Cigna Prior Authorization jobs? Cities with the most From Home Cigna Prior Authorization job openings:
What are the most commonly searched types of Cigna Prior Authorization jobs? The most popular types of Cigna Prior Authorization jobs are:
What states have the most From Home Cigna Prior Authorization jobs? States with the most job openings for From Home Cigna Prior Authorization jobs include:
Infographic showing various From Home Cigna Prior Authorization job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 87% Full Time, 10% Part Time, and 2% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution.
Prior Authorization Representative

Prior Authorization Representative

Vitreoretinal Surgery PLLC

Minneapolis, MN • Hybrid

Full-time

Medical, Dental, Vision, Life, PTO

Posted 9 days ago


Job description

Apply Here: https://secure.onehcm.com/ta/VRSPLLC.jobs?ShowJob=620913089&TrackId=ZipRecruiter

We are seeking a detail oriented and patient focused individual to work as a Prior Authorization Specialist at our Edina, MN business office (3 days in office / 2 days work from home).

If you have a passion for providing exceptional patient care, are highly personable, team-oriented, attuned to accuracy and fine detail, and would like to advance your career in the medical field, we would like to talk to you!

Responsibilities for a Prior Authorization Specialist include:

  • Coordinate prior authorization requests with insurance companies.
  • Use internal technology, reports and spreadsheets to determine if prior authorizations are necessary.
  • Request prior authorizations by website and phone.
  • Follow up on prior authorization requests.
  • Review approved prior authorizations and enters information into patient’s chart and account.
  • Review denied prior authorizations and appeals when appropriate.
  • Coordinate with clinic staff, physicians and co-workers to accomplish prior authorization process.

Required Skills, Abilities and Attributes for a Prior Authorization Specialist include:

  • Medical insurance experience
  • Empathy for patients
  • Solid understanding of medical terminology
  • High attention to detail
  • Strong computer experience (multi screens, heavy website navigation, speed and accuracy in moving from window to window, etc.)
  • 10 key by touch
  • 50 wpm typing
  • Experience with AllScripts software
  • Problem solving skills
  • Love to research and solve puzzles
  • Previous prior authorization experience
  • Willingness to have tough conversations with insurance companies
  • Strong organizational skills
  • One year experience with appeal submissions and/or medical billing and coding certificate strongly preferred
  • Ability to read and interpret EOBs
  • An overall understanding of appeals processes through completion
  • Efficient and highly accurate user of applicable information technology and health care management systems
  • Meticulous attention to detail and ability to complete the job with minimal errors
  • Ability to prioritize and manage time effectively
  • Knowledge of HIPAA guidelines
  • Excellent oral and written communication skills
  • Be an excellent team player who works cooperatively and respectfully with all doctors, supervisors, and co-workers.

We offer excellent compensation and benefits, to include:

  • Paid Holidays - 7 days per year
  • Personal Time Off (PTO) - 16 days per year
  • Health Insurance
  • Health Savings Account
  • Dental Insurance (100% company paid single coverage)
  • Flexible Spending Accounts
  • Basic and Supplemental Term Life Insurance (100% company paid single coverage)
  • Long Term Disability (free single coverage)
  • Long Term Care (100% company paid single coverage)
  • Short-Term Disability
  • Vision Insurance
  • Pet Insurance
  • Annual $250 uniform (scrubs and shoes) reimbursement

About Retina Consultants of Minnesota (RCM):

RCM has 9 Minnesota locations - St, Louis Park, Edina, Edina Specialty, Woodbury, Blaine, Duluth, Maplewood, Anoka, and Mankato.

Everything we do…. every decision we make…takes our Guiding Principles into consideration. Our guiding principles are:

  • We exist to serve our patients. We will provide the best available medical skills, technology, and service. We will be their advocates. We will care for our patients as if they were members of our family. We will treat our patients with respect, dignity, and kindness.
  • We are proud of our dedicated staff. We will strive to provide a rewarding career with opportunity for personal and professional growth. We will promote teamwork. We will provide a respectful and safe working environment.
  • We are humbled that other doctors entrust their patients to our care. We will be available when we are needed. We will promptly communicate the results of patient evaluation and treatment. We will respect the referring doctors’ relationships with their patients.
  • We recognize that we have a responsibility to our community. We will strive to be desire to perpetually “Learn and Grow”
  • Efficient and highly accurate user of applicable information technology and health care management systems
  • A good corporate citizen. We will function ethically. We will be prudent in our stewardship of healthcare resources.
  • Medical advances are critical to our patients. We will remain at the forefront in the search for new knowledge and treatments of retinal disease. We will participate in clinical research. We will share our knowledge with our patients and referring doctors, and with our retinal colleagues around the world.