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Insurance Prior Authorization Jobs in Remote, OR

Umpqua Health

Utilization Review Specialist

Winston, OR · On-site

$41K - $47K/yr

Track prior authorization requests using established systems to ensure timely processing. * Support ... Medical, dental, and vision insurance * 401(k) with company match (fully vested immediately)

Therapeutic Associates

Authorization Representative

OR · On-site +1

$17 - $20/hr

The position is responsible for managing daily physical therapy authorization requests, insurance ... and check insurance eligibility of new patients prior to initial appointment. Minimum ...

Evergreen Family Medicine

Referral Clerk

Roseburg, OR · On-site

$16.50 - $21/hr

Receives and coordinates all referrals and prior authorization requests, submitting appropriate information in a timely manner. * Maintain current knowledge of all insurances including verifying ...

Evergreen Family Medicine

Referral Clerk

Roseburg, OR · On-site

$16.50 - $21/hr

Receives and coordinates all referrals and prior authorization requests, submitting appropriate information in a timely manner. * Maintain current knowledge of all insurances including verifying ...

Evergreen Family Medicine

Referral Clerk

Roseburg, OR · On-site

$18.52 - $24/hr

Receives and coordinates all referrals and prior authorization requests, submitting appropriate information in a timely manner. * Maintain current knowledge of all insurances including verifying ...

Evergreen Family Medicine

Referral Clerk

Roseburg, OR · On-site

$16.50 - $21/hr

Receives and coordinates all referrals and prior authorization requests, submitting appropriate information in a timely manner. * Maintain current knowledge of all insurances including verifying ...

Umpqua Health

Customer Care Specialist

Roseburg, OR · On-site

$41K - $46K/yr

Educate members on health plan benefits, including provider access, prior authorization processes ... Experience working in healthcare, insurance, or public service settings. * Strong communication ...

Umpqua Health

Customer Care Specialist

Roseburg, OR · On-site

$41K - $46K/yr

Educate members on health plan benefits, including provider access, prior authorization processes ... Experience working in healthcare, insurance, or public service settings. * Strong communication ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · Remote

$85K - $105K/yr

This role conducts prior authorizations, facilitates care coordination, and supports safe ... Medical, dental, and vision insurance * 401(k) with company match (fully vested immediately)

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

This role conducts prior authorizations, facilitates care coordination, and supports safe ... Medical, dental, and vision insurance * 401(k) with company match (fully vested immediately)

Vensure Employer Services

Be Seen First

Medical Assistant

OR · Remote

$18.25 - $23.25/hr

Collect and verify patient demographics, insurance information, and intake documentation * Prepare patient charts before provider appointments * Coordinate prescriptions, prior authorizations, and ...

CTCLUSI

Pharmacy Biller

Coos Bay, OR · On-site

$17.75 - $22.75/hr

Initiates and tracks prior authorizations to support successful medication claim processing ... Assists patients with billing inquiries, insurance coverage questions, and payment responsibilities.

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Showing results 1-20

All JobsInsurance Prior Authorization JobsInsurance Prior Authorization Jobs in Remote, OR

Insurance Prior Authorization information

See Remote, OR salary details

$25.5K

$65.6K

$83.4K

How much do insurance prior authorization jobs pay per year?

As of Jul 13, 2026, the average yearly pay for insurance prior authorization in Remote, OR is $65,587.00, according to ZipRecruiter salary data. Most workers in this role earn between $60,900.00 and $76,900.00 per year, depending on experience, location, and employer.

What is insurance prior authorization?

Insurance prior authorization is a process where healthcare providers must obtain approval from a patient's insurance company before performing certain medical procedures, prescribing medications, or providing specific services. This ensures that the recommended treatment is covered under the patient's insurance plan and is deemed medically necessary. The process may involve submitting clinical information and waiting for a decision from the insurance provider. Prior authorization is intended to control costs and ensure appropriate care, but it can sometimes delay access to treatment.

Is prior authorization a stressful job?

Insurance prior authorization is often considered a stressful role due to the need for accuracy, meeting strict deadlines, and handling complex cases. The job requires strong attention to detail, communication skills, and familiarity with insurance policies and medical documentation, which can contribute to work-related stress.

What are the key skills and qualifications needed to thrive in Insurance Prior Authorization, and why are they important?

To thrive in Insurance Prior Authorization, you need a solid understanding of medical terminology, insurance policies, and healthcare regulations, often supported by experience in a healthcare or insurance setting. Familiarity with electronic health record (EHR) systems, insurance portals, and authorization management software is typically required. Attention to detail, strong organizational skills, and effective communication are critical soft skills for managing complex cases and coordinating with providers and payers. These competencies ensure timely approvals, reduce claim denials, and improve patient access to necessary medical treatments.

How much do precertification specialists make?

Precertification specialists typically earn between $35,000 and $55,000 annually, depending on experience, location, and employer. They often require knowledge of insurance policies and may use claims processing software as part of their role.

What jobs pay 4000 a week without a degree?

Insurance prior authorization specialists typically do not earn $4,000 weekly without relevant experience or certifications. High-paying roles that can reach this level often include sales positions, real estate brokers, or skilled trades like certain construction or electrical work, which may require licenses but not necessarily a college degree. These jobs often demand strong skills, experience, or licensing rather than formal education.

How to become a prior authorization specialist?

To become a prior authorization specialist, candidates typically need a high school diploma or equivalent, along with knowledge of insurance policies and medical terminology. Relevant skills include attention to detail, communication, and familiarity with electronic health record (EHR) systems. Certification in medical billing or coding can enhance job prospects.

What are some common challenges faced in an Insurance Prior Authorization role, and how can they be effectively managed?

One of the main challenges in Insurance Prior Authorization is navigating the varying requirements and documentation standards of different insurance providers. This often requires staying updated on policy changes and maintaining close attention to detail to prevent delays or denials. Effective communication with healthcare providers and insurance representatives is also essential, as misunderstandings or incomplete information can slow down the process. Building strong organizational skills and using robust tracking systems can help manage workloads and ensure timely approvals, ultimately supporting patient care.

What is the difference between Insurance Prior Authorization vs Insurance Claims Specialist?

AspectInsurance Prior AuthorizationInsurance Claims Specialist
Required CredentialsKnowledge of insurance policies, healthcare regulationsUnderstanding of claims processing, coding, documentation
Work EnvironmentHealthcare providers, insurance companies, hospitalsInsurance companies, healthcare organizations, billing departments
Employer & Industry UsageUsed to approve coverage before services are renderedHandles post-service claims, reimbursement processing
Search & Comparison IntentUnderstanding pre-authorization processClaims processing and reimbursement procedures

Insurance Prior Authorization involves obtaining approval from insurance companies before healthcare services are provided, ensuring coverage. In contrast, Insurance Claims Specialists process claims after services are rendered to secure payment. Both roles require knowledge of insurance policies but focus on different stages of the insurance process.

Insurance Prior Authorization jobs near you
Infographic showing various Insurance Prior Authorization job openings in Remote, OR as of July 2026, with employment types broken down into 1% As Needed, 88% Full Time, 10% Part Time, and 1% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $65,587 per year, or $31.5 per hour.
Utilization Review Specialist

Utilization Review Specialist

Umpqua Health

Winston, OR • On-site

$41K - $47K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 22 days ago

Job description

Utilization Review Specialist
HYBRID, must be able to travel to 3031 NE STEPHENS ST. ROSEBURG, OR 97470
EMPLOYMENT TYPE- Full-Time, Exempt
About Umpqua Health
At Umpqua Health, we're more than a healthcare organization we're a community-driven Coordinated Care Organization (CCO) dedicated to improving the health and well-being of individuals and families throughout Douglas County, Oregon. We provide integrated, whole-person care through primary care, specialty care, behavioral health services, and care coordination. Our collaborative approach ensures members receive high-quality, personalized care while supporting a stronger, healthier community.
POSITION PURPOSE
The Utilization Review Specialist supports Umpqua Health Alliance by coordinating the intake, review, processing, and completion of prior authorization requests within Medical Management. This role is responsible for ensuring accurate and timely handling of authorizations, maintaining compliance with regulatory and organizational requirements, supporting communication with providers and members, and assisting with workflow coordination to promote efficient utilization management operations.
ESSENTIAL JOB RESPONSIBILITIES
  • Support Utilization Review activities related to the prior authorization process.
  • Manage intake, tracking, and routing of prior authorization requests and supporting documentation.
  • Review requests for completeness and ensure appropriate routing for processing.
  • Communicate with healthcare providers to obtain additional information and resolve documentation issues.
  • Track prior authorization requests using established systems to ensure timely processing.
  • Support timely notification of prior authorization determinations.
  • Coordinate daily workflow and telephone coverage with team members.
  • Respond to internal and external inquiries regarding prior authorizations and route as appropriate.
  • Monitor and report on turnaround times to ensure compliance with requirements.
  • Maintain knowledge of applicable regulations, policies, and procedures.
  • Comply with organizational policies and applicable to federal, state, and local regulations.
CHALLENGES
  • Strong organizational skills with the ability to stay organized and productive in a remote, independent work environment
  • Proactive communication with internal and external stakeholders
  • Consistent ability to meet Oregon Health Plan (OHA) timeline and turnaround requirements
  • Ability to manage shifting priorities in a fast-paced environment
  • Ability to coordinate tasks and resources to meet operational goals and objectives
MINIMUM QUALIFICATIONS
  • High school diploma or equivalent.
  • Proficient computer skills, including Microsoft Office Suite (Word, Excel, Outlook, Teams), data entry, and internet research.
  • Experience using standard office equipment and systems, including keyboarding, web-based phone systems, and cloud-based document storage.
  • Ability to type a minimum of 45 words per minute with a high degree of accuracy.
  • Strong attention to detail.
  • No suspension, exclusion, or debarment from participation in federal healthcare programs (e.g., Medicare/Medicaid)
PREFERRED QUALIFICATIONS
  • 1+ years of experience in healthcare, managed care, medical coding, claims processing, or a related field
  • Knowledge of medical terminology, procedure codes, and diagnosis codes
  • Familiarity with Oregon Health Plan (OHP) and Coordinated Care Organizations (CCO), including applicable regulations (OAR, ORS, CFR, CMS, DMAP)
  • Strong organizational skills with the ability to manage multiple priorities in a fast-paced environment
  • Ability to meet deadlines while maintaining accuracy and attention to detail
  • Strong communication and customer service skills (written, verbal, and interpersonal)
  • Ability to work independently and collaboratively with sound judgment and confidentiality
  • Strong critical thinking and time management skills
  • Self-motivated with ability to follow policies, procedures, and workflows in a remote environment
  • Flexible and adaptable in a changing work environment
  • Willingness to learn and take on additional responsibilities as needed
  • Ability to work a standard schedule: Monday-Friday, 8:00 AM-5:00 PM PST
  • Experience working in diverse teams and with varied communication styles
  • Experience considering the impact of work on diverse communities, including communities of color
  • Bilingual or translation skills preferred

SCHEDULE
Monday through Friday - 8:00am - 5:00pm; standard business hours with flexibility to meet service timelines.
SALARY
Wage Band : $41,600- $47,000
BENEFITS
  • Salary is dependent on skills, experience, and education
  • Generous benefits package including vacation PTO, sick leave, federal holidays, and birthday leave
  • Medical, dental, and vision insurance
  • 401(k) with company match (fully vested immediately)
  • Company-sponsored life insurance and additional benefits
  • Fitness reimbursement program
  • Tuition reimbursement and more

Why Umpqua Health?
We are committed to advancing health equity by collaborating across communities, addressing systemic barriers, and ensuring fair access to care and resources. At Umpqua Health, every team member plays a vital role in making a meaningful impact, empowering healthier lives and strengthening the communities we serve.
Inclusive Culture
We foster a respectful, inclusive environment where employees feel valued, supported, and empowered.
Growth & Development
We support ongoing learning through mentorship, clear career pathways, and professional development opportunities.
Work/Life Balance
We promote flexibility and well-being so employees can thrive both professionally and personally.
Equal Opportunity
Umpqua Health is an equal opportunity employer that embraces individuals from all backgrounds. We prohibit discrimination and harassment of any kind, ensuring that all employment decisions are based on qualifications, merit, and the needs of the business. Our dedication to fairness and equality extends to all aspects of employment, including hiring, training, promotion, and compensation, without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, veteran status, or any other protected category under federal, state, or local law.

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