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Remote Aetna Prior Authorization Jobs in Indiana

$50K/yr

... verification, billing, prior authorizations, pharmacy coordination, etc. * Commitment to ... Fully remote within the United States. * Schedule: Part-time * Compensation: $50K-150K per year ...

$90 - $100K/hr

Performs site verification testing prior to cutting a site into a production environment ... Legal authorization to work in the U.S. indefinitely is required. Employer work permit sponsorship ...

New

Petersburg, FL 33702 Remote applicants may potentially be considered for this role. Osaic has ... Eligibility Applicants for employment in the US must have valid work authorization that does not ...

$231K - $288K/yr

... prior authorizations, pharmacy coordination, etc. * Patient Acquisition: Unlike with a private ... Fully remote within the United States. * Schedule: Full-time or part-time positions are available.

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Remote Aetna Prior Authorization information

What is a remote Aetna prior authorization specialist?

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 skills and qualifications are needed to thrive as a remote Aetna prior authorization specialist?

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 are common challenges faced by remote Aetna prior authorization specialists, 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 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.

Does Aetna offer remote positions?

Aetna offers remote positions for roles such as remote Aetna Prior Authorization specialists, allowing employees to work from home. These positions typically require familiarity with healthcare systems, prior authorization processes, and remote work tools like teleconferencing and electronic health records.

What cities in Indiana are hiring for Remote Aetna Prior Authorization jobs?

Cities in Indiana with the most Remote Aetna Prior Authorization job openings:

Prior Authorization Pharmacy Technician

Indiana University Health

Plainfield, IN • On-site, Remote

$17.25 - $20.75/hr

Full-time

Medical, Retirement

Posted 11 days ago


Indiana University Health rating

7.2

Company rating: 7.2 out of 10

Based on 465 frontline employees who took The Breakroom Quiz

345th of 891 rated healthcare providers


Job description

Overview

We are looking for team members who are passionate about challenging and significant work for the good of every patient. We are searching for individuals who are compassionate, serve with a purpose, are dedicated to supporting their team, and who seek excellence every day.

Sound like a perfect match? Apply now - we can't wait to hear from you!

Why Join IU Health?

As Indiana's largest and most comprehensive healthcare system, and the number 1 ranked healthcare system in Indiana, we offer:

  • 401(K) retirement savings with employer match
  • Tuition reimbursement
  • Student loan forgiveness - Government program that may allow qualifying participants to have the remainder of their student loan balance forgiven (after a set amount of time and specific qualifications have been met).
  • Employee Assistance Program - Counseling at no cost to you
  • Healthy Results - Participation in our team member wellness programs award points that contribute toward a biweekly financial incentive in your paycheck! The more you participate, the more you earn!

Prior Authorization Pharmacy Technician

Position Summary

IU Health has an exciting opportunity as we expand our Pharmacy Refill and Pharmacy Prior Authorization Departments. This position will be based in Plainfield, IN out of our Integrated Service Center but will eventually provide the opportunity for a hybrid/remote schedule.

The Prior Authorization Pharmacy Technician plays a vital role in supporting providers and patients by facilitating medication prior authorization requests with insurance payers. This position works closely with providers, clinical staff, pharmacists, and insurance companies to ensure timely and accurate completion of prior authorizations, helping patients gain access to necessary medications. Technicians in the prior authorization department work at the top of their license in Indiana, utilizing strong analytical skills, attention to detail, and medication knowledge. This is an excellent opportunity for experienced pharmacy technicians seeking to expand their skill set in a clinical, officebased environment.

Key Responsibilities

  • Initiate, process, and track prior authorization requests for prescription medications
  • Collaborate with providers and clinical staff to gather required clinical documentation and supporting information
  • Communicate with insurance companies and pharmacy benefit managers to determine coverage requirements and authorization status
  • Accurately document prior authorization activity, outcomes, and payer responses in the electronic medical record and pharmacy systems
  • Review medication requests for completeness, accuracy, and appropriateness prior to pharmacist review
  • Follow up on pending prior authorizations to ensure timely resolution and minimize delays in patient care
  • Communicate professionally with providers, clinic staff, and pharmacies regarding authorization status and next steps
  • Ensure all work complies with state regulations, payer guidelines, and organizational policies
  • Support pharmacists and the broader pharmacy team as needed

Knowledge, Skills, and Abilities

  • Strong attention to detail and ability to analyze insurance requirements and medication information
  • Solid knowledge of common drug names, therapeutic classes, and pharmacy terminology
  • Excellent written and verbal communication skills
  • Ability to manage multiple requests simultaneously while meeting deadlines
  • Strong organizational and problemsolving skills
  • Ability to work independently while contributing to a collaborative team environment
  • Commitment to accuracy, quality, and patient safety

Qualifications

  • High School Diploma or GED required
  • Active Indiana Pharmacy Technician License required
  • Minimum of one (1) year of pharmacy technician experience (retail experience preferred; hospital or clinic experience considered)
  • Prior authorization or insurancerelated experience preferred but not required
  • Requires Pharmacy Technician National Certification within one year of hire unless enrolled in accredited college of pharmacy or enrolled in or graduated from an ASHP/ACPE accredited Pharmacy Technician training program.   

Work Environment & Schedule

  • Officebased setting within a providersupported prior authorization team
  • Set schedule with no nights, weekends, or holidays
  • After an initial training period, partial remote work opportunities may be available based on performance, accuracy, and departmental metrics

Why Join This Team?

  • Work at the top of your pharmacy technician license in Indiana
  • Gain valuable experience in prior authorizations and insurance processes
  • Enjoy a predictable schedule that supports worklife balance
  • Be part of a collaborative, growing team in an officebased environment
  • Opportunity for professional growth and advancement within the pharmacy field
  • Indiana University Health has nearly 40,000 team members, including more than 3,600 physicians and 1,200 advanced practice providers, and we're home to the largest nursing network in Indiana with more than 9,000 nursing team members at over 800 sites of care.
  • IU Health is ranked No. 1 in Indiana by U.S. News & World Report, Riley Children's Health is ranked among the top children's hospitals in the country by U.S. News & World Report.
  • A unique partnership with the Indiana University School of Medicine - one of the nation's largest medical schools - gives patients access to groundbreaking research and innovative treatments, and it offers team members access to the latest science and the very best training - advancing healthcare for all.
  • With 15 hospitals, including seven with Magnet designation and eight with Pathways to Excellence designation, our team members are leading the way through excellence.
  • At Indiana University Health, your personal and professional growth is a top priority. You will have access to many diverse opportunities to learn and develop in meaningful ways that matter most to you, such as advanced clinical training, leadership development, promotion opportunities and cross training development.
  • Indiana University Health is invested in the lives of Hoosiers, leading the transformation of healthcare to make Indiana one of the nation's healthiest states.
Indiana University Health is Indiana's most comprehensive health system, with 15 hospitals and nearly 40,000 team members serving Hoosiers across the state. We're looking for team members who are inspired by challenging and meaningful work for the good of every patient. People who are compassionate and serve with a purpose. People who aspire to excellence every day.

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