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From Home Prior Authorization Rn Jobs in Ohio (NOW HIRING)

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All JobsPrior Authorization Rn JobsFrom Home Prior Authorization Rn JobsFrom Home Prior Authorization Rn Jobs in Ohio

From Home Prior Authorization Rn information

What is the difference between From Home Prior Authorization Rn vs From Home Medical Coder?

AspectFrom Home Prior Authorization RnFrom Home Medical Coder
CredentialsRN license, possibly certifications like CCMMedical coding certification (CPC, CCS)
Work EnvironmentHome-based, clinical settingHome-based, administrative setting
Industry UsageHealthcare, insurance, patient careHealthcare, billing, insurance claims

While both roles are remote healthcare positions, From Home Prior Authorization Rn focuses on reviewing medical necessity for insurance approvals, requiring nursing credentials. In contrast, From Home Medical Coder handles medical billing and coding, requiring coding certifications. Both roles support healthcare operations but differ in responsibilities and required qualifications.

What cities in Ohio are hiring for From Home Prior Authorization Rn jobs?

Cities in Ohio with the most From Home Prior Authorization Rn job openings:

From Home Prior Authorization Rn jobs near you

Prior Authorization Specialist (Remote after training)

Cincinnati, OH • On-site

DeCoach Recovery Centre
Outpatient Health Care • 201 - 500 employees
Learn more about DeCoach Recovery Centreexternal

$17.25 - $23/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 21 days ago

Job description

DeCoach Recovery is a leading addiction treatment center dedicated to providing compassionate care and effective solutions for individuals battling addiction. We take the time with every client to understand their needs and where they are on their recovery journey to help them not only reach sobriety, but to stay sober long-term.  


We are currently hiring for a prior authorization specialist to work at our Sharonville Headquarters. You will be responsible for obtaining necessary approvals from insurance providers prior to patients starting treatment or medications.  You will review clinical documentation, submit authorization requests, and communicate with healthcare providers and payers to ensure coverage requirements are met.  The role includes tracking requests, resolving issues and denials.  This position can become remote once training is completed. 

Minimum Qualifications:

  • High school diploma or equivalent; associate or bachelor’s degree preferred.
  • Minimum of 2 years experience in prior authorizations or in a revenue cycle role
  • Excellent communication and negotiation skills.
  • Proficiency with technology including Microsoft Office Suite


Responsibilities:

  • Verify patient eligibility and coverage limits

  • Review medical charts to ensure clinical notes match what insurance requires

  • Send requests for prior approval to insurance providers

  • Track pending cases and follow up with insurance agents



Benefits:

  • Medical, Dental and Vision Benefits
  • Yearly Merit Raises
  • A Company Matched 401(k) plan
  • Tuition Reimbursement
  • STAR Eligible Facilities to Assist with Student Loan Forgiveness
  • PTO and Paid Holidays
  • Opportunities for Advancement