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Prior Authorization Jobs in Remote, OR (NOW HIRING)

CONFEDERATED TRIBES OF CLUSI

Pharmacy Biller

Coos Bay, OR

$17.25 - $22.25/hr

Initiates and tracks prior authorizations to support successful medication claim processing. Contacts third-party payors via phone, email, or fax to follow up on outstanding accounts (30, 60, 90, or ...

SuperCare Health

Customer Care Specialist

Roseburg, OR · On-site

$16.25 - $21.50/hr

Verifies payer (with matrix), obtains authorization, expiration date * Verifies patient demographics and prior equipment usage with patient * Informs patient of financial responsibilities: copay ...

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All JobsPrior Authorization JobsPrior Authorization Jobs in Remote, OR

Prior Authorization information

See Remote, OR salary details

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$20

$32

How much do prior authorization jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for prior authorization in Remote, OR is $20.87, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $23.08 per hour, depending on experience, location, and employer.

What is prior authorization?

Prior authorization is a process used by health insurance companies to determine if they will cover a prescribed procedure, service, or medication. Before the provider delivers the service, they must receive approval from the insurer. This process helps control costs and ensures that the service or medication is medically necessary. It often involves submitting documentation and waiting for a decision, which can sometimes delay patient care. Patients and providers should check with insurance companies to understand which services require prior authorization.

What are the key skills and qualifications needed to thrive as a prior authorization specialist, and why are they important?

To thrive as a Prior Authorization Specialist, you need strong knowledge of medical terminology, insurance processes, and healthcare regulations, typically supported by a high school diploma or associate degree in a healthcare-related field. Familiarity with electronic medical records (EMR) systems, insurance portals, and authorization management software is essential. Attention to detail, effective communication, and problem-solving abilities help you navigate complex cases and collaborate with providers and payers. These skills ensure accurate and timely processing of authorizations, minimizing delays in patient care and reducing administrative errors.

What are some common challenges faced by prior authorization specialists, and how can applicants prepare for them?

Prior Authorization specialists often encounter challenges such as navigating complex insurance policies, managing high volumes of requests, and communicating effectively with both healthcare providers and insurance representatives. To prepare for these challenges, applicants should develop strong organizational skills, attention to detail, and a good understanding of medical terminology and insurance guidelines. Familiarity with electronic health records (EHR) systems and the ability to multitask in a fast-paced environment are also valuable assets in this role.

What is the difference between Prior Authorization vs Medical Billing Specialist?

AspectPrior AuthorizationMedical Billing Specialist
CredentialsTypically requires knowledge of insurance policies, healthcare regulations, and sometimes certifications like NCQA or AHIPRequires knowledge of coding, billing procedures, and often certifications like CPC or CCS
Work EnvironmentHealthcare provider offices, insurance companies, or hospitalsMedical offices, billing companies, or healthcare facilities
Employer & Industry UsageUsed by healthcare providers and insurers to approve treatments or proceduresUsed by healthcare providers and billing companies to process claims and payments

While both roles are essential in healthcare administration, Prior Authorization focuses on obtaining approval for treatments, whereas Medical Billing Specialists handle the financial aspects of claims processing. Understanding their differences helps clarify their distinct responsibilities within the healthcare system.

How do I become a prior authorization specialist?

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

What career paths follow prior authorization?

Careers following prior authorization include roles such as medical billers, claims processors, healthcare administrators, and utilization review specialists. These positions often require knowledge of insurance policies, medical coding, and healthcare regulations, and may involve certifications like CPC or CCS. Advancement can lead to supervisory or managerial roles within healthcare administration or insurance companies.

What is a prior authorization job?

A prior authorization job involves reviewing and processing requests from healthcare providers to approve specific medical treatments, medications, or procedures before they are administered. The role requires knowledge of insurance policies, medical terminology, and attention to detail, often utilizing electronic health record systems. It is essential for ensuring that treatments meet insurance criteria and are covered under the patient's plan.
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What cities near Remote, OR are hiring for Prior Authorization jobs?

Cities near Remote, OR with the most Prior Authorization job openings:

Prior Authorization jobs near you
Infographic showing various Prior Authorization job openings in Remote, OR as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 18% Part Time, 1% Temporary, and 3% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $43,417 per year, or $20.9 per hour.

Pharmacy Biller

Confederated Tribes of Coos Lower Umpqua and Siuslaw Indians

Coos Bay, OR • On-site

$24.65/hr

Full-time

Re-posted 24 days ago

Job description

Job Type
Full-time
Description
The Pharmacy Biller is responsible for the accurate and timely processing of pharmacy billing and reimbursement activities. This role reviews claims, resolves denials, and supports patients with billing and insurance inquiries. The position collaborates closely with internal teams and third-party payors to ensure compliance with applicable regulations and supports the financial performance of the pharmacy.
PRINCIPAL ACTIVITIES & RESPONSIBILITIES
• Prepares, submits, and monitors pharmacy billing claims to ensure accurate and timely reimbursement from third party payors.
• Researches, resolves, and follows up on denied or rejected claims, including initiating appeals when appropriate.
• Initiates and tracks prior authorizations to support successful medication claim processing.
• Contacts third-party payors via phone, email, or fax to follow up on outstanding accounts (30, 60, 90, or 120+ days).
• Posts payments, adjustments, and reconciles accounts to maintain accurate billing records.
• Assists patients with billing inquiries, insurance coverage questions, and payment responsibilities.
• Maintains current knowledge of Medicare, Medicaid, Workers' Compensation, VA, and private insurance requirements, including coverage guidelines and billing regulations.
• Ensures compliances with HIPAA and all applicable federal, state, and organizational billing regulations and policies.
• Monitors formulary and coverage changes for key payors and communicates billing regulations and policies.
• Monitors formulary and coverage changes for key payors and communicates updates to the pharmacy team to reduce claim rejections and delays.
• Collaborates with Pharmacy, Business Office, Patient Financial Services, Alternate Resources and IT teams to support efficient billing processes and resolve claim issues.
• Tracks and analyzes billing trends, reimbursement patterns, and denial rates; provides reports and recommendations for process improvement to department leadership.
• Monitors and supports billing procedures and systems to improve efficiency, accuracy, and compliance. Maintains accurate and complete billing documentation and records for auditing and reporting purposes.
• Supports the implementation and reporting of pharmacy related billing programs and initiatives.
• Collaborates efficiently and effectively while consistently demonstrating professionalism and maintaining positive, respectful relationships with internal teams, external partners, and Tribal members.
• Other duties as directed by management.
LEVEL OF AUTHORITY & RESTRICTIONS
• This position requires working independently without overseeing others, with minimal authority in decision-making.
PHYSICAL & MENTAL DEMANDS
• Must be able to walk, talk, hear, use hands to handle, feel or operate objects, tools, or controls, and reach with hands and arms.
• Vision abilities required by this job include close vision and the ability to adjust focus.
• May be required to push, pull, lift, and/or carry up to 30 pounds.
• Must be able to stand, walk, reach with hands and arms, and climb or balance.
• Must be able to sit and type/work on a computer.
• Must be able to stand for long periods of time.
WORKING CONDITIONS & ENVIRONMENT
• Moderate noise level with frequent interruptions and distractions.
• Must be willing and able to travel both locally and within the CTCLUSI service delivery area and work at locations other than Three Rivers Health Center.
LOCATION
Three Rivers Health Center
150 S. Wall Street
Coos Bay, OR 97439
Requirements
• Must be 18 years of age or older.
• Minimum of two (2) years of experience in medical billing, pharmacy billing, or a related healthcare revenue cycle role.
• Working knowledge of pharmacy or medical billing terminology and coding standards (e.g. NCPDP, HCPCS, ICD-10).
• Experience and proficiency in the use of Microsoft products (Excel, Outlook, PowerPoint, Word, etc.).
• Proficient in using electron health records (EHR) and pharmacy information systems for documentation and medication management.
• Strong organizational skills with the ability to prioritize tasks, manage time effectively, and work in a fast-paced environment.
• Ability to communicate clearly and effectively in English, verbally, in writing or by other acceptable means.
• This position is considered a covered role. A state criminal background check and fingerprint-based background check will be required as a condition of employment.
• This position is designated as safety-sensitive and is subject to pre-employment and other authorized drug and alcohol testing in accordance with company policy. Please note that the use of marijuana is prohibited for employees in this position, regardless of state legalization status.
• Must have employment eligibility in the U.S.
• Indian preference will be observed in the hiring process.
Salary Description
$24.65/DOE

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