ZipRecruiter

Log In

1

From Home Cigna Prior Authorization Jobs in Renton, WA

Conflux Systems

*Pharmacy Tech I

Seattle, WA · On-site

$21.29/hr

This position takes in-coming calls from members, providers, etc providing professional phone assistance to all callers through the criteria based prior authorization process, and transfers all ...

Walgreens

Specialty Billing Technician

Seattle, WA

$20.75 - $26.75/hr

Ensure all Medicare documentation is received from the medical provider and submitted to Danville ... Processing of prescription exceptions including prior authorizations, triaging of referrals to ...

Walgreens

Specialty Billing Technician

Seattle, WA · On-site

$20.75 - $26.75/hr

Ensure all Medicare documentation is received from the medical provider and submitted to Danville ... Processing of prescription exceptions including prior authorizations, triaging of referrals to ...

previous pagenext page

Showing results 21-40

All JobsCigna Prior Authorization JobsFrom Home Cigna Prior Authorization JobsFrom Home Cigna Prior Authorization Jobs in Renton, WA

From Home Cigna Prior Authorization information

What is a from home Cigna Prior Authorization specialist?

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 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 are the key skills and qualifications needed to thrive as a 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.

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 popular job titles related to From Home Cigna Prior Authorization jobs in Renton, WA?

For From Home Cigna Prior Authorization jobs in Renton, WA, the most frequently searched job titles are:

What job categories do people searching From Home Cigna Prior Authorization jobs in Renton, WA look for?

The top searched job categories for From Home Cigna Prior Authorization jobs in Renton, WA are:

From Home Cigna Prior Authorization jobs near you

Admissions Coordinator, Home Health

Wesley At-Home

Federal Way, WA • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 20 hours ago

Job description

We understand that finding a place to belong is important. At Wesley, we care about your development, we are committed to continuous improvement, and we all grow together.
Wesley is a place where your energy and enthusiasm are welcome and your talents are developed. A place where you feel recognized, valued and rewarded. A place where you can dedicate yourself to caring for others, knowing that you are part of an organization that is equally dedicated to caring for you and your career.
Our Total Rewards philosophy takes a balanced approach, designed to support employees at every stage of their career journey. We review our offerings annually to ensure they remain meaningful. In addition to competitive wages and a commitment to pay equity, we offer the following benefits and other compensation:
Health & Insurance Benefits
  • Employees, and their families if elected, can participate in medical insurance (full time and ACA eligible), dental (full time), vision (full time) and group life (employee only coverage - full time)

Time Off & Holidays
  • We offer a combined paid time off (PTO) policy which incorporates state paid sick leave with company paid time off at an accrual rate of 0.0607 per hour worked, equivalent to 120 hours of PTO at 2,080 hours worked in a year. The PTO accrual rate increases after two years of service and again after five years of service
  • We offer 6 Paid Holidays (8 hours - full time, 6 hours - part-time per event, excluding on-call staff) and 1 Personal Holiday of Choice per year (excluding on-call staff)

Retirement & Financial Well-Being
  • Retirement planning is encouraged through our 403(b) plan that includes a generous 100% company match on the first 4% of earnings an employee contributes. There is a 5-year vesting schedule for the company match, and minors are ineligible for the company match
  • Gain access to your net earnings when you need it with on-demand pay through Dayforce Wallet

Perks & Wellness
  • To assist employees with challenges outside of the workplace, Wesley offers an Employee Assistance Program (EAP), which is 100% company paid. Additionally, Wesley Community Foundation provides grants to qualifying employees for both emergency assistance and educational advancement
  • A food and beverage discount of 50% is available to all employees at any Wesley bistro and marketplace

Recognition That Matters
  • The efforts and contributions of our valued employees are celebrated on our best-in-class recognition and reward platform, Inspire. Points earned for assorted reasons may be redeemed for a variety of merchandise, gift cards, cash cards, tickets, travel and other experiences selected by the employee

Wesley is two-time winner of the LeadingAge Washington Excellence in the Workplace Award.
This summary is intended to reflect the most reasonable and genuinely expected offering of benefits and other compensation for the posted job. The official website for all Wesley job postings is https://wesleychoice.org/careers/. Wesley is not responsible for content on third-party job boards. Salary ranges, benefits and other compensation are subject to change.
Enrich the lives of older adults through community, choice, and continuing care in the Admissions Coordinator, Home Health role. This role receives, evaluates, processes and coordinates admission-related tasks for home care and hospice such as verification of coverage, authorizations, patient data entry, communications between parties including families, and resolving billing-related issues. The Admissions Coordinator, Home Health also plays a lead role in day-to-day staff scheduling and compliance with Home Health Medicare guidelines. Find your sense of belonging at Wesley!
You will provide continuing care through these responsibilities Essential functions of this position include the following.
1. Receives and processes all requests for services.
  • Record/log the request for services and make follow-up calls as necessary
  • Reviews referral information for appropriateness, under the direction of Director of Clinical Services and Director of Business Operations. Reviews based on Medicare Guidelines
  • Assigns and schedules referrals into the electronic medical record according to agency policies and procedures; maintains timely and accurate records
  • Informs clinical staff of newly assigned patients and status of all disciplines involved. Monitors that admissions and discipline evaluations are completed as ordered and scheduled. Communicates with the Director of Clinical Services as necessary
  • Verifies Medicare and third-party payor coverage as a ring of defense

2. Establishes system for prior authorization from third-party payers.
  • Implements procedures for completing and filing reimbursement forms
  • Compiles documentation and orders required for billing. Tracks that visits are made within authorization parameters
  • Provides requested information to insurance companies for reimbursement
  • Communicates effectively verbally and in writing with representatives of insurance companies/other payers
  • Communicates with families and patients regarding the coverage for home health services

3. Demonstrates teamwork and effective communication to achieve Home Health goals.
  • Works with community referral sources, families, and Home Health staff to problem solve and identify services available to the patient either through company services or community partners
  • Participates in Home Health orientation for new staff in matters pertinent to patient insurance information, scheduling admission visits, and coordination of secondary discipline evaluations
  • Follows up on patient transition to home. Communicates with referral sources regarding status of referrals

4. Other duties and special projects as assigned.
Our requirements and qualifications for success
  • Ability to read, write and communicate proficiently in English
  • Excellent communication skills (verbal and written), interpersonal skills, and documentation skills
  • Proficiency with Microsoft Office and other workplace technology including cloud-based software and mobile apps
  • Experience or understanding of the regulatory components of home health and hospice
  • Knowledge of community resources, Medicare and state regulations, and reimbursement criteria for third-party and private payers
  • Self-motivated, self-directed, excellent organizational skills, and ability to effectively manage stress
  • Critical thinking skills and ability to adapt to changing priorities a must
  • Ability to work independently and with minimal supervision

Physical, environmental, and mental requirements
  • Ability to sit, stand or walk at-will throughout shift
  • Ability to hear, understand, and distinguish speech and/or other sounds one-to-one, in a group, and via telephone/computer
  • Keyboarding and near visual acuity
  • Ability to lift up to 25 lbs

Salary Range: $26.04 to $37.53 per hour

Apply