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From Home Cigna Prior Authorization Jobs in Renton, WA

Proliance Surgeons

Auth/Ben Specialist Lead

Tacoma, WA · On-site

$20.96 - $33.54/hr

We hire and support people from diverse backgrounds, fostering growth and development to make ... Perform and support the full scope of prior authorization and insurance verification ...

Proliance Surgeons

Auth/Ben Specialist Lead

Tacoma, WA · On-site

$60 - $80/hr

We hire and support people from diverse backgrounds, fostering growth and development to make ... Perform and support the full scope of prior authorization and insurance verification ...

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 ...

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 ...

Sound Pain Alliance

Procedure Coordinator

Silverdale, WA · On-site

$21 - $25/hr

Coordinate and schedule patient procedures from start to finish * Obtain and manage prior authorizations, including submitting documentation and insurance follow-up * Communicate clearly and ...

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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.

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

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From Home Cigna Prior Authorization jobs near you

Hospital Authorization Specialist (Remote)

Cardiac Study Center

Tacoma, WA • Remote

$22.08 - $35.88/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 5 days ago

Job description

Hospital Authorization Specialist
Cardiac Study Center, Tacoma WA (Remote)

Who We Are

At Cardiac Study Center, our mission is to elevate patient health through compassionate, innovative cardiology care.

We're a dedicated team at the forefront of cardiovascular medicine, empowering patients with the knowledge and treatment they need to lead heart-healthy lives. As a growing organization with deep roots in the Pacific Northwest, we are looking for passionate individuals to join us in making a real impact on our patients' heart health and well-being. Here, you'll have the opportunity to collaborate with top professionals, advance in your career, and make a meaningful difference every day.


Why should you work with us?

  • Cutting-edge processes: Join a team that uses advanced systems to streamline pre-authorizations and approvals, ensuring patients receive timely care while optimizing operational workflows.
  • Professional growth and development: At Cardiac Study Center, we foster continuous learning and encourage team members to develop skills that advance their careers in healthcare administration.
  • Collaborative culture: Work closely with providers, schedulers, and insurance companies in a team-oriented environment where every role plays a part in delivering exceptional patient care.
  • Make an impact: As a Hospital Authorization Specialist, your work ensures that patients' hospital procedures are appropriately authorized and efficiently coordinated, making a meaningful difference in their healthcare experience.


The Position
The Hospital Authorization Specialist is a vital role ensuring the seamless authorization of hospital procedures for our patients. This role involves coordinating with providers, insurance companies, and hospital staff to secure necessary pre-authorizations, address denials, and maintain accurate records.

Your Day-to-Day Work

  • Review and manage daily hospital procedure schedules to identify pre-authorization needs.
  • Obtain authorizations from insurance companies using phone, fax, and online portals.
  • Verify that CPT and ICD-10 codes align with scheduled procedures and insurance requirements.
  • Collaborate with providers to handle peer-to-peer requests and appeal denied authorizations.
  • Communicate with patients about procedure approvals, reschedules, or cancellations.
  • Read medical charts to ensure procedures align with providers' plans.
  • Work closely with hospital pre-service teams to confirm all authorizations are accurate and complete.
  • Maintain up-to-date knowledge of insurance guidelines and ensure compliance with all HIPAA regulations.


Environment and Shift Details
This is a full-time, remote position, operating Monday through Friday. The role requires extensive computer work, phone communication, and occasional handling of lightweight materials.


Experience & Qualifications

Must-Haves

  • High School Diploma or GED.
  • 1-3 years of experience in medical authorization, healthcare administration, or a related field.
  • Strong understanding of medical terminology and insurance guidelines.
  • Excellent attention to detail and organizational skills.

Nice-to-Haves

  • Familiarity with ICD-10 and CPT coding.
  • Prior experience with pre-authorizations or appeals processes.
  • Experience using healthcare systems like EPIC or other EMR platforms.


Pay and Benefit Expectations

While you're focused on ensuring seamless authorization processes for our patients, we are focused on taking care of you with benefits such as:

  • Comprehensive health insurance (with zero-cost premiums).
  • Dental & vision plans.
  • FSA/HSA options.
  • Retirement matching.
  • Paid vacation & floating holidays.
  • Mental health support, and more!

The pay scale for this position is $22.08- $35.88, influenced by your experience, skill set, and education.

Join our team and help ensure patients receive the timely care they deserve!