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From Home Cigna Prior Authorization Jobs (NOW HIRING)

OneOncology

Prior Authorization Specialist

Huntsville, AL · On-site

$17.25 - $23/hr

Responsible for tracking, obtaining, and extending authorizations from various carriers in a timely manner. * Check daily, weekly, and monthly schedules for prior authorizations and request necessary ...

New

1840 & Company

$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 ...

Claim Health

Prior Authorization Specialist

Manhattan, NY · On-site

$19.75 - $26.50/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 ...

PharMerica

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 ...

Curant Health

Prior Authorization Specialist

Smyrna, GA · On-site

$18 - $24/hr

... 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 ...

Curant Health

Prior Authorization Specialist

Smyrna, GA · On-site

$18 - $24/hr

... 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 ...

BrightSpring

Prior Authorization Specialist

Louisville, KY

$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 ...

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All JobsHealthcare JobsFrom Home Cigna Prior Authorization Jobs

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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From Home Cigna Prior Authorization jobs near you
Infographic showing various From Home Cigna Prior Authorization job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 22% Part Time, and 3% Contract. Highlights an 75% Physical, 1% Hybrid, and 24% Remote job distribution.

Prior Authorization Specialist

Cornerstone Family Healthcare

Middletown, NY • On-site

$21/hr

Other

Medical, Retirement, PTO

Re-posted 7 days ago

Job description

Prior Authorization Specialist

Cornerstone Family Healthcare is actively recruiting for a Prior Authorization Specialist to join our growing team in Middletown, NY.

RATE OF PAY/SALARY: $21.00 per hour

WORK LOCATION(S): Middletown, NY

STATUS: Full-time

CORNERSTONE'S MISSION:

Cornerstone Family Healthcare is a non-profit Federally Qualified Health Center with a mission to provide high quality, comprehensive, primary and preventative health care services in an environment of caring, dignity and respect to all people regardless of their ability to pay. For more than fifty years, Cornerstone has been responsive to meeting the needs of the communities in which we serve with a continued emphasis on the underserved and those without access to health care regardless of race, economic status, age, sex, sexual orientation or disability.

CORNERSTONE BENEFITS:

Competitive salaries Health Benefits Retirement plan Paid Time Off Sick Time Flexible Spending Dependent Care Paid Holidays

Job Duties:

  • Assists patients in obtaining prior authorizations for treatment requiring insurance pre-authorization.
  • Handles all prior authorization submissions to proper insurances.
  • Documents in EMR authorization status, actions, and outcomes.
  • Communicates well with internal providers to obtain all the required information to submit prior authorization efficiently.
  • Has medical terminology knowledge, i.e. ICD, CPT, Procedure Codes/Names, & Test Names.
  • Responsible for notifying the appropriate internal departments of any information that they need to be aware of, including complaints or adverse event notifications.
  • Communicates and builds relationships with insurance carriers and servicing providers or facilities.
  • Schedule peer to peer meeting between CFH provider and insurance company for prior authorization denials.
  • Request and prepare supporting documentation for the medical necessity for the service being authorized, examples include medical records, labs, previous prior authorization(s), appeals, denials and prescriptions.
  • Sorts daily work queues and is accountable to identify and process the daily work.
  • Performs initial insurance benefit verification and pre-surgical authorization for new OB/GYN or Podiatry surgical cases.
  • Advises Provider and patients of any changes or cancellations of surgical/procedure bookings.
  • Fields phone calls from staff and service providers and resolves inquiries related to prior authorizations.
  • Easily manages multiple authorization requests at once.
  • Exemplifies excellent customer service with patients, visitors, and other employees; shows courtesy, friendliness, helpfulness, and respect.
  • Consistently demonstrates respect for the capabilities, different cultures and/or personalities of internal and external customers.
  • Maintains and ensures patient privacy and confidentiality.
  • Takes the initiative to proactively assist others.
  • Maintains open and effective communication with providers and employees to ensure quality.
  • Perform other related duties as assigned

Requirements:

  • Bilingual (English & Spanish)
  • At least one-year clerical experience in a health-related field
  • Knowledge of data entry
  • Pleasant telephone manner

Apply