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Full Time Remote Prior Authorization Jobs in Tennessee

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Full Time Remote Prior Authorization information

What is the difference between Full Time Remote Prior Authorization vs Full Time Remote Medical Coder?

AspectFull Time Remote Prior AuthorizationFull Time Remote Medical Coder
CredentialsTypically requires healthcare-related certifications (e.g., CPC, RHIT)Usually requires coding certifications (e.g., CPC, CCS)
Work EnvironmentRemote, administrative healthcare settingRemote, medical documentation and coding environment
Industry UsageInsurance, healthcare administrationHospitals, clinics, insurance companies
Job FocusReviewing and approving prior authorization requestsAnalyzing medical records and assigning codes

Full Time Remote Prior Authorization and Full Time Remote Medical Coder roles share remote work settings and healthcare industry usage. However, prior authorization focuses on reviewing approval requests, while medical coding involves analyzing medical records for billing purposes. Both require healthcare certifications but serve different functions within healthcare organizations.

Full Time Remote Prior Authorization jobs near you
Infographic showing various Full Time Remote Prior Authorization job openings in Tennessee as of August 2026, with employment types broken down into 5% As Needed, 74% Full Time, and 21% Part Time. Highlights an 42% In-person, 5% Hybrid, and 53% Remote job distribution.

Revenue Cycle Associate - Financial Clearance

Quorum Health

Brentwood, TN • Remote

Full-time

Medical, Retirement, PTO

Posted 12 days ago

Quorum Health rating

6.5

Company rating: 6.5 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

Job description

Revenue Cycle Associate - Financial Clearance

Employment Type: Full Time
Location:  Remote
Reports To: Manager, Financial Clearance

You must reside in one of these states to be eligible for this position:

Arkansas                  California                 Kentucky
Massachusetts                Nevada                    New Mexico
Oregon                  Utah                      Tennessee
Texas                     Wyoming

Job Summary:

The Revenue Cycle Associate, Financial Clearance position is responsible for ensuring that a patient’s visit is financially cleared prior to the date of service. The role includes verifying patient insurance eligibility/benefits, calculating patient liability estimates, securing prior authorization, providing notice of admission, obtaining referrals, and verifying medical necessity. These efforts will result in increased net revenues by reducing front-end related denial write-offs. Interactions will be conducted with providers, payers, patients, and hospital-based personnel. Duties are to be performed accurately and timely while providing exceptional customer service.

Key Responsibilities:

  • Ensures Financial Clearance (e.g., verification of eligibility/ benefits, securing prior authorization, etc.) is obtained timely prior to the patient’s date of service based on service line and departmental policies.
  • Performs coverage discovery using eligibility tools to identify additional insurance coverage if existing insurance on file is inactive.
  • Calculates and clearly documents patient liability estimates based on patient’s verified benefit information.
  • Provides payers with timely inpatient and observation Notices of Admission (NOA) as required based on payer-specific guidelines.
  • Validates prior authorization has been obtained and follows up with providers via phone as required for applicable services lines.
  • Verifies medical necessity for applicable patients and identifies instances where a Medicare Advance Beneficiary Notices of Noncoverage (ABN or NONC) is required.
  • Escalates instances where Financial Clearance may not be obtained (e.g., unable to obtain authorization) prior to patient’s DOS to appropriate stakeholders in accordance with departmental deferral policies.
  • Resolves insurance coverage and authorization information discrepancies as identified through automated quality assurance tool.
  • Works denials related to referral, authorizations, notifications, non-coverage, and medical necessity as assigned. This includes, but is not limited to, coordinating with appropriate stakeholders to submit rebills or appeals and obtaining retro authorization when required.
  • Observes privacy, safety, and security procedures, and uses equipment and materials properly.
  • Possesses the ability to work within a remote call center environment, free from distractions and background noise. 
  • Recognizes and consistently exhibits exceptional customer service as a critical factor in all duties performed.

Required Skills & Qualifications:

  • Proficient in typing.
  • General knowledge of medical terminology.
  • Ability to communicate effectively and professionally in English, both verbally and in writing. 
  • Critical thinking and problem-solving skills.
  • High school graduate or equivalent.
  • One year of related experience in the medical field is preferred. 

Benefits:

  • Competitive salary and benefits package.
  • Opportunities for professional development and advancement.
  • Supportive work environment with a collaborative team.
  • Comprehensive healthcare coverage.
  • Retirement savings plan.
  • Paid time off and flexible scheduling options.
  • Student loan repayment program.

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