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Remote Medical Authorization Jobs in Raleigh, NC

Psychologist Reviewer

Durham, NC ยท On-site +1

$87K - $157K/yr

Interact with the Medical Director, or designee, to discuss clinical authorization questions and ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

... of their medical records, your mastery of the program requirements, and ensuring their ... This includes completing benefit investigations, tracking prior authorizations / denial appeals ...

Episodic Care Manager

NC ยท On-site +1

$29 - $39/hr

Episodic Care Manager Location: 100% Remote Duration: 5-6 Months Pay Range: $29-$39/hr. on W2 ( The ... using medical policies, benefits, care guidelines, and regulations. * Make authorization ...

New

Medical, dental, vision plans, disability, and life insurance coverage for you and your family that ... For global locations, you must have established and current work authorization and permanently ...

Medical, dental, vision plans, disability, and life insurance coverage for you and your family that ... For global locations, you must have established and current work authorization and permanently ...

High Voltage Test Engineer

Raleigh, NC ยท Remote

$105K - $158K/yr

... remote, travel expectations between 50%-60%. * Candidate must already have work authorization that ... Health Care (medical, dental, vision, etc.) * Financial Wellbeing : (Employer sponsored pension ...

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Remote Medical Authorization information

What is a remote medical authorization specialist?

A Remote Medical Authorization specialist is a professional who reviews and processes medical authorization requests from healthcare providers, typically working from a remote location. Their main responsibility is to ensure that medical procedures, treatments, or medications meet specific criteria for insurance coverage or regulatory compliance before approval. They communicate with providers, insurance companies, and sometimes patients to gather necessary information and make informed decisions. This role requires a strong understanding of medical terminology, insurance policies, and healthcare regulations. Remote Medical Authorization specialists play a crucial role in streamlining healthcare access while managing cost and compliance.

What are the key skills and qualifications needed to thrive as a remote medical authorization specialist?

To thrive as a Remote Medical Authorization Specialist, you need a solid understanding of medical terminology, insurance procedures, and prior authorization processes, usually backed by experience in healthcare administration or a related field. Familiarity with electronic health records (EHR) systems, insurance portals, and authorization management software is typically required. Strong attention to detail, effective communication, and organizational skills are crucial for handling complex cases and collaborating across teams. These competencies are vital for ensuring timely, accurate authorizations that support patient care and optimize reimbursement.

What are some common challenges faced by professionals in a remote medical authorization role, and how can they be effectively managed?

Professionals in a Remote Medical Authorization role often encounter challenges such as coordinating with multiple healthcare providers, managing a high volume of authorization requests, and ensuring compliance with complex insurance policies. Effective communication skills, attention to detail, and strong organizational abilities are essential for managing these demands. Utilizing digital tools and maintaining up-to-date knowledge of payer guidelines can help streamline workflows and reduce errors. Building strong relationships with both clinical teams and insurance representatives also supports smoother case resolution.

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

AspectRemote Medical AuthorizationRemote Medical Billing Specialist
Required CredentialsMedical license, certification in medical authorization or prior authorizationMedical billing certification, knowledge of coding and insurance
Work EnvironmentHealthcare providers, insurance companies, remoteMedical offices, insurance companies, remote
Industry UsageUsed to obtain prior approvals for treatments or proceduresHandles billing, coding, and insurance claims processing

Remote Medical Authorization focuses on obtaining prior approvals for medical procedures, requiring medical credentials. Remote Medical Billing Specialists handle billing and coding tasks, often requiring billing certifications. Both roles are essential in healthcare but serve different functions within the industry.

What cities near Raleigh, NC are hiring for Remote Medical Authorization jobs?

Cities near Raleigh, NC with the most Remote Medical Authorization job openings:

Collaborating Psychiatrist / Supervising Physician (MD or DO) -- Remote | Telehealth | Part-Time | No

Cary, NC โ€ข Remote

Legion Health
Health Care and Social Assistanceย โ€ขย 1 - 10 employees

$50K - $150K/yr

Part-time

Posted 27 days ago


Job description

[We show compassion to heal minds.]

 
About Legion Health

Legion Health is a technology-forward psychiatry company delivering world-class outpatient mental health care while expanding access for patients through insurance.

We are seeking exceptional Collaborating Psychiatrists (MD or DO) across the United States to collaborate with and supervise psychiatric mental health nurse practitioners through secure telehealth workflows.

Our innovative model combines the stability of a traditional hospital position with the flexibility of a private practice. We prioritize our clinicians' well-being and professional growth, offering a competitive compensation package and fostering a vibrant, collaborative culture.

Quality and patient experience are paramount to us. This means recruiting exceptional providers, championing evidence-based protocols, and displaying compassion in every patient interaction. Our exceptional psychiatrists operate with clinical autonomy, supported by experienced peers.

Our vision is to pioneer a new era of medicine by delivering world-class psychiatry. We believe in a future where every person can access the compassionate, high-quality care they need.

 
About the Role

Legion Health is seeking clinically excellent, patient-centered psychiatrists to collaborate with and supervise PMHNPs through secure telehealth workflows. This nationwide, remote, part-time contractor opportunity combines predictable flexibility with meaningful clinical responsibility and the support of a modern clinical organization.

Legion recruits and vets the PMHNPs and manages the operational infrastructure, while you provide responsive clinical guidance, chart review, mentorship, and independent prescribing decisions when legally permitted and clinically appropriate.

 
Benefits

Legion’s model is built to give clinicians more time for patients, fewer administrative distractions, and the support of a high-caliber psychiatric community.

  • Flexibility: Set your own schedule for optimal work-life balance.

  • Work from Home: Collaborate with PMHNPs through secure telehealth and clinical systems.

  • Significant Administrative Support: You focus on patient care, and we’ll handle scheduling, insurance verification, billing, prior authorizations, pharmacy coordination, etc.

  • Commitment to Responsible Prescribing and High-Quality Care: We have rigorous, evidence-based protocols and provide objective diagnostic tools to ensure responsible and ethical prescriptions of controlled substances.

  • Legal Protection: We provide full malpractice insurance coverage.

  • PMHNP acquisition: Legion recruits and vets the PMHNPs you support.

  • Clinical autonomy: Exercise independent medical judgment within clear, evidence-based protocols.

  • Licensure and DEA Coverage: We’ll reimburse you for all fees associated with getting licensed in other states as required by Legion.

  • Credentialing Support: We handle all aspects and costs of credentialing with a large number of insurance plans, including commercial, ACA, and government, ensuring your legal and effective authorization within insurance networks.

  • Community of Clinical Excellence: You will work alongside the most talented psychiatrists and PMHNPs in the world. Our current providers have trained at some of the country’s most prestigious institutions.

  • Monthly Pay: We pay our providers every month for immediate financial benefit and planning ease.

  • Culture of Excellence through Innovation: Actively participate in ushering in a new era of mental health care through superior clinical care and technology.

  • Resources: We provide premium subscriptions to resources such as UpToDate and Carlat.

  • Exclusive Events: Engage with your colleagues through exclusive in-person and virtual events.

 
✅ Responsibilities
  • Collaborate with experienced PMHNPs treating low- and medium-acuity psychiatry patients using evidence-based approaches.

  • Conduct chart reviews and provide timely guidance on diagnoses, treatment plans, medication management, and clinical escalations.

  • Review and authorize prescriptions, including controlled substances when legally permitted and clinically appropriate.

  • Be available during agreed working hours and at the end of PMHNP shifts when required by applicable state rules.

  • Mentor clinicians and reinforce Legion's clinical standards, documentation expectations, and responsible-prescribing protocols.

  • Help Legion expand access to high-quality psychiatric care across the United States.

 
Qualifications
  • An active, unrestricted license to practice medicine in at least one U.S. jurisdiction.

  • Strong clinical assessment, diagnostic, and medication-management skills.

  • Excellent communication and interpersonal skills.

  • Comfort providing care remotely and using electronic health record systems.

  • Commitment to patient-centered, compassionate, evidence-based care.

 
Role Logistics
  • Location: Fully remote within the United States.

  • Schedule: Part-time

  • Compensation: $50K-150K per year, depending on the number and workload of PMHNPs supervised

 
Clinical Advisory Board

Legion’s Clinical Advisory Board brings together nationally recognized psychiatrists, physician executives, telepsychiatry pioneers, and primary-care leaders. Working closely with Legion’s medical leadership, they help shape our clinical quality standards, evidence-based care protocols, prescribing safeguards, risk-management practices, and continuous quality-improvement efforts as the company scales.

Members of our clinical advisory board include:

  • Madhukar Trivedi, M.D. — Psychiatrist; Professor of Psychiatry and Distinguished Chair in Mental Health at UT Southwestern

  • Alexander Ruvalcaba, M.D. — Psychiatrist; Physician Executive at MultiCare Behavioral Health Network

  • Jon Kole, M.D. — Psychiatrist; Senior Medical Director at Headspace

  • Liberty Eberly, D.O. — Psychiatrist; Co-Founder and Former Chief Medical Officer at innovaTel Telepsychiatry

  • John Lusins, M.D. — Psychiatrist; Founder and President at South Texas Mental Health Associates

  • Jacqueline Champlain, M.D. — Family Medicine Physician; Lead Physician at WellMed and Fellow of the American Academy of Family Physicians

 
✨ Bring Your Best Clinical Work to Legion

If you are a thoughtful, evidence-based psychiatrist who wants the flexibility of remote practice, meaningful clinical autonomy, robust operational support, and a community committed to excellent psychiatric care, we would be excited to learn more about you.

 
Equal Employment Opportunity

Legion Health is proud to be an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees, contractors, and applicants without regard to race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, disability, veteran status, genetic information, or any other protected characteristic under applicable law. We encourage applicants from all backgrounds to apply.

Compensation Range: $50K - $150K