Birmingham, AL · Remote
$50 - $60/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Birmingham, AL · Remote
$50 - $60/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Mobile, AL · Remote
$49.75 - $59.75/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Mobile, AL · Remote
$49.75 - $59.75/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Mobile, AL · On-site +1
$48.75 - $59.50/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Mobile, AL · On-site +1
$48.75 - $59.50/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Birmingham, AL · On-site +1
$49 - $59.75/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Birmingham, AL · On-site +1
$49 - $59.75/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Montgomery, AL · Remote
$54K - $155K/yr
Position Summary This is a remote work from home role anywhere in the US with virtual training ... Utilization Review. * CCM and/or other URAC recognized accreditation preferred. * 1+ years ...
Montgomery, AL · Remote
$54K - $155K/yr
Position Summary This is a remote work from home role anywhere in the US with virtual training ... Utilization Review. * CCM and/or other URAC recognized accreditation preferred. * 1+ years ...
Daphne, AL · On-site +1
$14.75 - $18.25/hr
Overview Insurance Verification Specialist (Remote) Location: Southern Cancer Center Employment ... Review and update patient demographic and insurance information as needed. * Document a brief ...
Daphne, AL · On-site +1
$14.75 - $18.25/hr
Overview Insurance Verification Specialist (Remote) Location: Southern Cancer Center Employment ... Review and update patient demographic and insurance information as needed. * Document a brief ...
Job Title Commercial Insurance Analytics Consultant - Remote Requisition Number R7735 Commercial ... Reviews and guides work performed by less senior analysts , delegating components of analysis ...
Job Title Commercial Insurance Analytics Consultant - Remote Requisition Number R7735 Commercial ... Reviews and guides work performed by less senior analysts , delegating components of analysis ...
Birmingham, AL · On-site +1
$55K - $65K/yr
All Locations/Remote Role Type: Full time Salary: $55,000 - $65,000 per year + Sales Incentive ... Review Life Applications for completeness and notify Agents/FA's and VP's of missing forms or ...
Birmingham, AL · On-site +1
$55K - $65K/yr
All Locations/Remote Role Type: Full time Salary: $55,000 - $65,000 per year + Sales Incentive ... Review Life Applications for completeness and notify Agents/FA's and VP's of missing forms or ...
Birmingham, AL · On-site +1
$55K - $65K/yr
All Locations/Remote Role Type: Full time Salary: $55,000 - $65,000 per year + Sales Incentive ... Review Life Applications for completeness and notify Agents/FA's and VP's of missing forms or ...
Birmingham, AL · On-site +1
$55K - $65K/yr
All Locations/Remote Role Type: Full time Salary: $55,000 - $65,000 per year + Sales Incentive ... Review Life Applications for completeness and notify Agents/FA's and VP's of missing forms or ...
Birmingham, AL · On-site +1
$55K - $65K/yr
All Locations/Remote Role Type: Full time Salary: $55,000 - $65,000 per year + Sales Incentive ... Review Life Applications for completeness and notify Agents/FA's and VP's of missing forms or ...
Birmingham, AL · On-site +1
$55K - $65K/yr
All Locations/Remote Role Type: Full time Salary: $55,000 - $65,000 per year + Sales Incentive ... Review Life Applications for completeness and notify Agents/FA's and VP's of missing forms or ...
Birmingham, AL · On-site +1
$55K - $65K/yr
All Locations/Remote Role Type: Full time Salary: $55,000 - $65,000 per year + Sales Incentive ... Review Life Applications for completeness and notify Agents/FA's and VP's of missing forms or ...
Birmingham, AL · On-site +1
$55K - $65K/yr
All Locations/Remote Role Type: Full time Salary: $55,000 - $65,000 per year + Sales Incentive ... Review Life Applications for completeness and notify Agents/FA's and VP's of missing forms or ...
Birmingham, AL · Remote
$120 - $164/hr
At the same time, only 30% of therapists accept insurance. UpLift acts as the bridge between ... utilization of add-on codes (such as 90833) when clinically appropriate and properly documented
Quick apply
Birmingham, AL · Remote
$120 - $164/hr
At the same time, only 30% of therapists accept insurance. UpLift acts as the bridge between ... utilization of add-on codes (such as 90833) when clinically appropriate and properly documented
$97K - $130K/yr
Review and approve invoices for costs and attorneys' fees * Perform / assist initial evaluation for ... insurance claims and resolution This role is open to remote candidates across the U.S. However ...
$97K - $130K/yr
Review and approve invoices for costs and attorneys' fees * Perform / assist initial evaluation for ... insurance claims and resolution This role is open to remote candidates across the U.S. However ...
Our mission is to reinvent commercial insurance in the mobility space to offer our partners ... Review work of Consultants and Analysts and oversees the successful completion of projects within ...
Our mission is to reinvent commercial insurance in the mobility space to offer our partners ... Review work of Consultants and Analysts and oversees the successful completion of projects within ...
Sylacauga, AL · On-site +1
Conduct structured reviews of clinical records to assess service utilization, client engagement ... Resolve barriers such as transportation, insurance, or documentation needs. * Risk Identification ...
Sylacauga, AL · On-site +1
Conduct structured reviews of clinical records to assess service utilization, client engagement ... Resolve barriers such as transportation, insurance, or documentation needs. * Risk Identification ...
Birmingham, AL · Remote
$14/hr
... insurance, and claims support. This is a remote position for those that reside in = AL, GA, ID, IA ... Resource & System Utilization * Utilize Privia-approved billing systems, EMR platforms, tools, and ...
Birmingham, AL · Remote
$14/hr
... insurance, and claims support. This is a remote position for those that reside in = AL, GA, ID, IA ... Resource & System Utilization * Utilize Privia-approved billing systems, EMR platforms, tools, and ...
Birmingham, AL · On-site +1
$14/hr
... insurance, and claims support. This is a remote position for those that reside in = AL, GA, ID, IA ... Resource & System Utilization * Utilize Privia-approved billing systems, EMR platforms, tools, and ...
Birmingham, AL · On-site +1
$14/hr
... insurance, and claims support. This is a remote position for those that reside in = AL, GA, ID, IA ... Resource & System Utilization * Utilize Privia-approved billing systems, EMR platforms, tools, and ...
$129K - $172K/yr
Manage claim budget, review and approve outside counsel invoices and other expenses and determine ... Specific expertise with title insurance, escrow and lender matters highly desirable * Must possess ...
$129K - $172K/yr
Manage claim budget, review and approve outside counsel invoices and other expenses and determine ... Specific expertise with title insurance, escrow and lender matters highly desirable * Must possess ...
Birmingham, AL · Remote
$120K - $216K/yr
... level review. * Assessment of the claims and providing an analysis to the client and carrier ... Medical, dental, vision, life and disability insurance * 401(k) Retirement Plan * Flexible Spending ...
Birmingham, AL · Remote
$120K - $216K/yr
... level review. * Assessment of the claims and providing an analysis to the client and carrier ... Medical, dental, vision, life and disability insurance * 401(k) Retirement Plan * Flexible Spending ...
$42.75 - $58.75/hr
... Insurance Group (CSAA IG), a AAA insurer, is one of the leading personal lines property and ... Review test results and support issues resolution in alignment with business stake-holders.
$42.75 - $58.75/hr
... Insurance Group (CSAA IG), a AAA insurer, is one of the leading personal lines property and ... Review test results and support issues resolution in alignment with business stake-holders.
| Aspect | Remote Insurance Utilization Review | Remote Claims Reviewer |
|---|---|---|
| Credentials | Typically requires nursing or healthcare-related certifications, such as RN or licensed healthcare professional | Usually requires insurance or claims processing knowledge, sometimes with certifications like CPC or CPC-H |
| Work Environment | Remote, healthcare or insurance company settings, reviewing medical necessity and appropriateness of services | Remote, insurance companies or third-party administrators, reviewing claims for accuracy and compliance |
| Industry Usage | Commonly used in healthcare insurance to evaluate medical necessity | Used across insurance sectors to process and validate claims |
Remote Insurance Utilization Review focuses on assessing the medical necessity of services, often requiring healthcare credentials. Remote Claims Reviewers handle claims processing and validation, emphasizing insurance knowledge. Both roles are remote and industry-specific but differ in their primary responsibilities and required qualifications.
$50 - $60/hr
Other
Posted 16 days ago
Remote Prior Authorization Pharmacist - Work From Home in Managed Care
A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription requests, ensure medical necessity, and improve patient access to safe and effective therapies. This work-from-home position is ideal for pharmacists who want to transition out of retail or hospital settings while building expertise in managed care.
Key Responsibilities
What You'll Bring
Why This Role?
About Us
We are a confidential healthcare partner working with health plans and PBMs across the U.S.. Our pharmacists ensure patients receive the right therapy at the right time while maintaining compliance with all regulations.
Apply Today
Take the next step in your career with our Remote Prior Authorization Pharmacist opportunity - and enjoy the benefits of working from home while shaping the future of managed care.
