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Remote Optum Prior Authorization Jobs in Kansas (NOW HIRING)

UnitedHealth Group

Clinical Admin Coordinator

Lenexa, KS · Remote

$18 - $32/hr

Optum is a global organization that delivers care, aided by technology to help millions of people ... Oversee Prior Authorization, including, submission, notification, appeals, follow-up, and ...

UnitedHealth Group

Intake Coordinator

Overland Park, KS · Remote

$17.75 - $24.25/hr

Optum is a global organization that delivers care, aided by technology to help millions of people ... Manages the referrals process, processes incoming and outgoing referrals, and prior authorizations.

Stryker

$35/hr

Must be legally authorized to work in the U.S. and not require employment-based sponsorship now or ... Prior exposure to claims databases (Medicare, MarketScan, Premier PINC AI, Optum) or EHR data ...

Stryker

$35/hr

Must be legally authorized to work in the U.S. and not require employment-based sponsorship now or ... Prior exposure to claims databases (Medicare, MarketScan, Premier PINC AI, Optum) or EHR data ...

Stryker

$35/hr

Must be legally authorized to work in the U.S. and not require employment-based sponsorship now or ... Prior exposure to claims databases (Medicare, MarketScan, Premier PINC AI, Optum) or EHR data ...

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Remote Optum Prior Authorization information

What is a Remote Optum Prior Authorization?

A Remote Optum Prior Authorization job involves reviewing and processing requests from healthcare providers to determine whether certain medical procedures, medications, or services will be covered under a patient's insurance plan. Employees in this role work from home and use clinical guidelines to assess the necessity and appropriateness of requested treatments. They collaborate with providers, patients, and insurance teams to ensure timely authorization decisions. This position typically requires strong communication skills, attention to detail, and familiarity with healthcare regulations and insurance policies.

How does a Remote Optum Prior Authorization specialist typically interact with healthcare providers and insurance teams?

As a Remote Optum Prior Authorization specialist, you will regularly communicate with healthcare providers, pharmacies, and insurance representatives to obtain and verify necessary information for authorizing medical procedures or medications. Most interactions occur via phone, secure messaging, or electronic health record systems, requiring clear communication and attention to detail. Collaboration is essential, as you'll often need to clarify clinical documentation with providers and ensure compliance with insurance guidelines. This role is well-suited for those who are organized, proactive, and comfortable working independently within a supportive virtual team environment.

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

To thrive as a Remote Optum Prior Authorization Specialist, you need strong knowledge of medical terminology, insurance processes, and prior authorization protocols, typically supported by a healthcare-related degree or relevant experience. Familiarity with electronic health record (EHR) systems, insurance verification tools, and prior authorization software is essential. Excellent attention to detail, organizational skills, and effective communication are vital soft skills for efficiently managing high volumes of authorization requests and collaborating with providers. These skills ensure accurate, timely approvals and help optimize patient care while reducing administrative delays.

What is the difference between Remote Optum Prior Authorization vs Remote Optum Claims Reviewer?

AspectRemote Optum Prior AuthorizationRemote Optum Claims Reviewer
CredentialsTypically requires healthcare-related certifications, such as RN, LPN, or medical coding credentialsOften requires similar healthcare certifications, with focus on claims processing
Work EnvironmentRemote, healthcare insurance setting, interacting with providers and patientsRemote, insurance claims processing environment, reviewing submitted claims
Employer & Industry UsageCommonly employed by health insurance companies like Optum, focusing on authorization processesEmployed by insurance companies, focusing on claims review and reimbursement

Remote Optum Prior Authorization specialists focus on obtaining approvals for healthcare services, while Remote Optum Claims Reviewers evaluate submitted claims for accuracy and reimbursement. Both roles require healthcare knowledge and certifications, but differ in their primary functions within the insurance process.

What are popular job titles related to Remote Optum Prior Authorization jobs in Kansas?

For Remote Optum Prior Authorization jobs in Kansas, the most frequently searched job titles are:

What job categories do people searching Remote Optum Prior Authorization jobs in Kansas look for?

The top searched job categories for Remote Optum Prior Authorization jobs in Kansas are:

What cities in Kansas are hiring for Remote Optum Prior Authorization jobs?

Cities in Kansas with the most Remote Optum Prior Authorization job openings:

Remote Optum Prior Authorization jobs near you
Infographic showing various Remote Optum Prior Authorization job openings in Kansas 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.

*New - Prior Authorization Specialist (Experience)- Remote

Nyx Health

Kansas City, KS • On-site, Remote

$21 - $23/hr

Full-time

Posted 2 days ago

New

Job description

Prior Authorization Specialist - Remote
Position Summary
We're looking for a driven, detail-oriented individual to join our team as a Prior Authorization Specialist. You'll receive training and ongoing support to set you up for success. As part of this role, you'll complete accurate insurance verifications and prior authorizations to ensure timely reimbursement. You'll also collaborate with clinicians and insurance payors in a fast-paced environment to manage claims, documentation, and approvals. If you enjoy problem-solving, staying organized, and making a meaningful impact-both independently and as part of a team-we'd love to hear from you.
Key Responsibilities
  • Pharmacy Benefits PA Submissions
  • Navigating EMR/PM systems for demographic information, patient clinical notes, and labs.
  • Coordinate initial submission of prior authorization processes including preparation of PA, answering Prior Authorization clinical questions, submitting Pharmacy benefit PA's
  • Utilize covermymeds to complete submission of Prior Authorizations
  • Communicate with providers and insurance companies regarding authorization status.
  • Maintain HIPAA compliance and support daily revenue cycle operations.
  • Aprima experience+

Skills & Qualifications
  • 3-5 years rheumatology medication PA experience is Required
  • Specialty Pharmacy experience - Required
  • 5+ years of prior authorization experience -Required
  • Knowledge of rheumatology medications and biosimilars -Required
  • Proficient in EMR systems, Covermymeds, ECW, NextGen Emrs
  • Strong communication, problem-solving, and organizational skills.
  • Detail-oriented, analytical, and able to multitask in a fast-paced environment.

Education & Experience
  • High School Diploma required; additional education in business or healthcare preferred.
  • Experience in prior authorization, utilization review, insurance verification, and EMR systems. [preferred]

Work Environment & Physical Requirements
  • Remote position
  • Prolonged computer use; ability to lift up to 15 lbs.

Job Type, Schedule & Compensation
  • Full-time, Monday-Friday, 8-hour day shift.
  • Pay: $21-$23 per hour, [With additional pay available for exceptional experience.]

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