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Remote Aetna Prior Authorization Jobs (NOW HIRING)

CareMed Specialty Pharmacy

$23 - $25/hr

Pharmacy Prior Authorization Specialist - CareMed Specialty Pharmacy Buffalo, NY | Full-Time | ... Remote work possible after initial on-site training. Company Benefits * Medical; Dental; Vision ...

PainPoint

Prior Authorization Coordinator

Atlanta, GA · On-site +1

$19 - $21/hr

Prior Authorization Coordinator Full-Time | $19-21/hour | Monday-Friday | 8:00 AM-4:30 PM CST ... Remote About DxTx Pain & Spine At DxTx Pain & Spine, we're redefining how pain and spine practices ...

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Remote Aetna Prior Authorization information

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$87K

$134.7K

$189K

How much do remote aetna prior authorization jobs pay per year?

As of Jun 17, 2026, the average yearly pay for remote aetna prior authorization in the United States is $134,701.00, according to ZipRecruiter salary data. Most workers in this role earn between $104,000.00 and $163,500.00 per year, depending on experience, location, and employer.

What are some common challenges faced by professionals in a Remote Aetna Prior Authorization role, and how can they be managed?

Professionals in a Remote Aetna Prior Authorization role often encounter challenges such as navigating complex insurance criteria, managing high volumes of authorization requests, and communicating effectively with healthcare providers and patients. Staying organized, maintaining up-to-date knowledge of Aetna's policies, and utilizing digital workflow tools can help manage these demands. Regular communication with team members and ongoing training are also key to ensuring accurate and timely authorizations while working remotely.

What are remote Aetna prior authorization jobs?

Remote Aetna prior authorization jobs involve reviewing and processing requests for medical procedures, medications, or services to determine if they meet Aetna insurance's coverage criteria. Employees in these roles work from home, typically as part of a healthcare team, to ensure that patients receive necessary care while adhering to Aetna's policies. Responsibilities may include evaluating clinical documentation, communicating with healthcare providers, and making authorization decisions based on established guidelines. These positions often require knowledge of medical terminology, insurance processes, and strong attention to detail.

What are the key skills and qualifications needed to thrive as a Remote Aetna Prior Authorization Specialist, and why are they important?

Success as a Remote Aetna Prior Authorization Specialist requires a strong understanding of medical terminology, insurance processes, and prior authorization guidelines, often supported by experience in healthcare administration or certification such as a Certified Medical Administrative Assistant (CMAA). Familiarity with electronic health record (EHR) systems, Aetna's proprietary platforms, and insurance verification tools is typically needed. Outstanding attention to detail, problem-solving abilities, and effective communication with providers and patients are crucial soft skills. These skills ensure timely and accurate authorization decisions, reduce claim errors, and provide a positive experience for both healthcare providers and members.

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

AspectRemote Aetna Prior AuthorizationRemote Medical Billing Specialist
CredentialsInsurance, healthcare, or medical administration certificationsMedical billing or coding certifications
Work EnvironmentHealthcare insurance companies, remote or office-basedMedical offices, hospitals, or remote billing companies
Industry UsageHealth insurance providers, specifically AetnaHealthcare providers, billing companies, insurance payers

Remote Aetna Prior Authorization specialists focus on obtaining approval for medical services from Aetna insurance, requiring knowledge of insurance policies and authorization procedures. Remote Medical Billing Specialists handle billing, coding, and claims processing for healthcare providers. While both roles involve healthcare and insurance, the primary difference lies in their responsibilities: authorization versus billing. Understanding these distinctions helps job seekers find the right role aligned with their skills and certifications.

More about Remote Aetna Prior Authorization jobs
What cities are hiring for Remote Aetna Prior Authorization jobs? Cities with the most Remote Aetna Prior Authorization job openings:
What are the most commonly searched types of Aetna Prior Authorization jobs? The most popular types of Aetna Prior Authorization jobs are:
What states have the most Remote Aetna Prior Authorization jobs? States with the most job openings for Remote Aetna Prior Authorization jobs include:
What job categories do people searching Remote Aetna Prior Authorization jobs look for? The top searched job categories for Remote Aetna Prior Authorization jobs are:
Remote Aetna Prior Authorization jobs near you
Infographic showing various Remote Aetna Prior Authorization job openings in the United States as of June 2026, with employment types broken down into 80% Full Time, 10% Part Time, and 10% Temporary. Highlights an 100% Remote job distribution, with an average salary of $134,701 per year, or $64.8 per hour.
Prior Authorization Specialist (Remote, Contract Only)

Prior Authorization Specialist (Remote, Contract Only)

Medix

Minneapolis, MN • On-site, Remote

$24/hr

Full-time

Posted 16 days ago

Job description

We are seeking a detail-oriented and motivated Prior Authorization Specialist to join our team in a fully remote capacity, on a temporary basis. This role is critical to the revenue cycle, ensuring that insurance authorizations, benefits, and price estimates are accurately secured before patients receive care.
You will be part of a dynamic team supporting five facilities across multiple specialties, including Radiology, Infusion/Injections, and Surgery. While you will be assigned specific facilities, you will also support our "sister facilities" to ensure seamless operations across the network.
Position Overview
  • Work Hours: 9:00 AM - 5:00 PM EST
  • Location: 100% Remote
  • Volume: Approximately 1,700 - 2,000 cases per month (Average annual volume of 20,230)
  • Software: All work is managed through EPIC work queues.

Key Responsibilities
  • Authorization & Verification: Initiate and follow up on authorizations for inpatient and outpatient services (Radiology, Infusion, Surgical, Diagnostic/Procedural Cardiology, etc.).
  • Payer Relations: Interact directly with payers to verify benefits and secure notice of admissions. You will work with NY State Medicare, Wellcare, Fidelis, Humana, Aetna, and United Healthcare.
  • Financial Clearance: Aim to achieve a 95% financial clearance rate at least one day prior to service, with a long-term goal of clearing cases 14 days out.
  • Data Accuracy: Utilize EPIC eligibility reports to verify insurance and document all "touches" accurately.
  • Efficiency: Maintain a production pace of 6-12 minutes per touch to meet a goal of 80% of total KPI targets.

Qualifications
Must-Haves:
  • Proficiency with EPIC (Experience with EPIC work queues is essential).
  • Prior experience or strong understanding of Insurance Authorizations.
  • Solid command of Medical Terminology.

Nice-to-Have Skills:
  • Experience specifically within Radiology, Infusion, or Surgical specialties.

Note on Experience: While specific years of experience in this exact role aren't required, you must be comfortable navigating healthcare portals.
* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
* As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
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About Medix Staffing Solutions

Sourced by ZipRecruiter

Since 2001, we’ve been dedicated to helping you achieve your goals. Medix was created to become a leading provider of workforce solutions for clients and candidates across the healthcare and life sciences industries. Today, we are that leader. Headquartered in Chicago, we have 23 offices across the United States, and staff talent around the world. Medix is committed to fulfilling our core purpose as an organization: to positively impact the lives of our talent, clients, and teammates through employment, philanthropy, and opportunity. The combination of purpose and values has nurtured our thriving culture that encourages our internal team to excel at work and in everyday life.

Industry

Recruiting and staffing services

Company size

1,001 - 5,000 Employees

Headquarters location

Chicago, IL, US

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