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Remote Optum Prior Authorization Jobs in Wisconsin

HTM Contract Manager

Burlington, WI ยท Remote

$47.50 - $71.25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

This role is primarily remote with possibility of travel as needed for meetings, training, or ... rate summaries, prior authorization requirements and other contract operational documents.

New

Financial Specialist

Madison, WI ยท On-site +1

$22.76/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Any remote work must be performed from Wisconsin. This position is FLSA Non-Exempt. Anticipated ... Applicants must be legally authorized to work in the United States (i.e., a citizen or national of ...

New

Certified Medical Coder

Milwaukee, WI ยท Remote

$24.87/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Remote Facility: Remote Department: Revenue Cycle Management Schedule: Full-time | Day Shift Salary ... obtained prior to hire date or job transfer date. All specialties accepted. * Certified ...

New

Certified Medical Coder

Milwaukee, WI ยท Remote

$24.87/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Remote Facility: Remote Department: Revenue Cycle Management Schedule: Full-time | Day Shift Salary ... obtained prior to hire date or job transfer date. All specialties accepted. * Certified ...

New

Certified Medical Coder

Milwaukee, WI ยท Remote

$24.87/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Remote Facility: Remote Department: Revenue Cycle Management Schedule: Full-time | Day Shift Salary ... obtained prior to hire date or job transfer date. All specialties accepted. * Certified ...

New

Financial Specialist FCC

Hawkins, WI ยท On-site +1

$22.76/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Any remote work must be performed from Wisconsin. This position is FLSA Non-Exempt. Anticipated ... Applicants must be legally authorized to work in the United States (i.e., a citizen or national of ...

New

Psychologist Supervisor

Oshkosh, WI ยท On-site +1

$141K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Any remote work must be performed from Wisconsin. Anticipated schedule will be Monday - Friday 7:45 ... Applicants must be legally authorized to work in the United States (i.e. a citizen or national of ...

Correctional Officer

Green Bay, WI ยท On-site +1

$35.37/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Candidates with no prior permanent employment with the State of Wisconsin in the past five (5) ... Job Details Applicants must be legally authorized to work in the United States (i.e. a citizen or ...

Physician

Stanley, WI ยท On-site +1

$205K - $262K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Job Details Applicants must be legally authorized to work in the United States (i.e. a citizen or ... This position is not eligible for remote work Shift: 1.0 FTE- days of the week will be determined ...

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Showing results 1-20

Remote Optum Prior Authorization information

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 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.

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.

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

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

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

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

Infographic showing various Remote Optum Prior Authorization job openings in Wisconsin as of August 2026, with employment types broken down into 86% Full Time, and 14% Part Time. Highlights an 100% Remote job distribution.

Client Support Representative (REMOTE-Wisconsin)

Aston Carter

Milwaukee, WI โ€ข On-site, Remote

$20/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago


Job description

Job Title: Client Support Representative (AI Patient Access Specialist) - WISCONSIN
** if you are interested in this opportunity, please feel free to apply and email me your resume at alalfaro @ astoncarter.com so we can schedule a time to connect asap! **
Job Description
This role serves as a next-generation contact center position in the healthcare field, acting as the human-in-the-loop between AI-led conversations and traditional insurance verification. You will monitor and guide AI-driven calls between healthcare representatives and insurance agents, step in when human interaction is required, and ensure that all insurance verification and prior authorization details are accurately documented. By supporting and training the AI system through real-time interactions, you help streamline access, adherence, and affordability for patients across the healthcare reimbursement landscape.
Responsibilities
  • Monitor AI-led agent-to-agent conversations between healthcare representatives and insurance agents to ensure accuracy and continuity.
  • Guide AI interactions by selecting appropriate prompts, responses, questions, and next steps during live calls.
  • Take over calls when the AI cannot respond to an agent's question, when an agent prefers to speak with a human, or when a carrier or contract requires human interaction.
  • Review notes from existing conversations and quickly pick up where another specialist or the AI left off to maintain a seamless experience.
  • Conduct insurance verification by confirming eligibility, benefits, and coverage details with insurance agents.
  • Gather and document prior authorization information and perform related follow-up activities as needed.
  • Capture complete and accurate information before concluding each call or interaction.
  • Maintain detailed notes during and after conversations, ensuring all insurance verification and authorization information is properly recorded.
  • Update internal systems with all relevant details from each interaction and verify that information is complete and accurate before closing out the case.
  • Manage both outbound and inbound call workflows while consistently maintaining quality, accuracy, and professionalism.
  • Use AI tools, multiple computer systems, and screens simultaneously to support efficient call handling and documentation.
  • Follow established processes, scripts, and workflows while remaining solution-oriented and focused on resolving issues.
  • Collaborate with AI-driven technology by providing clear, accurate inputs that help improve system performance over time.
  • Demonstrate strong listening, comprehension, and communication skills to build rapport with insurance agents and other stakeholders.
  • Absorb information quickly from previous notes, understand the status of ongoing interactions, and continue conversations without missing critical details.
  • Continuously adapt to new technology, workflows, and process improvements to enhance patient access and coordination of care.

Essential Skills
  • High School Diploma or GED.
  • Basic computer proficiency and the ability to learn new systems and tools.
  • Proven data entry and documentation skills with strong attention to detail.
  • Experience navigating multiple systems and screens simultaneously.
  • Customer service experience (at least 6 months) in a call center, customer support, or similar environment.
  • Strong listening, comprehension, and verbal communication skills.
  • Ability to provide a high level of customer service and professionalism in all interactions.
  • Solution-oriented mindset with the ability to resolve issues and follow through.
  • Ability to work independently while following directions and established processes.
  • Capability to quickly absorb information from previous notes and continue conversations seamlessly.
  • Coachable and adaptable to new technology, AI tools, and evolving workflows.
  • Experience with call center operations, call monitoring, and call support.
  • Proficiency in data entry management and administrative support tasks.
  • Comfort working in healthcare-related environments, including insurance verification and prior authorization support.
  • Familiarity with Microsoft Office or similar productivity tools.

Additional Skills & Qualifications
  • Experience in healthcare administration or customer service, such as Healthcare Receptionist, Medical Office Assistant, Healthcare Call Center Representative, Patient Access Representative, Pharmacy Technician or Support, Medical Administrative Assistant, Healthcare Internship, or recent college graduate experience.
  • Experience in customer care, client services, or client support roles.
  • Front desk or administrative support experience in a healthcare or insurance setting.
  • Exposure to process improvement initiatives within call centers or administrative environments.
  • Understanding of healthcare insurance verification, benefits, eligibility, and prior authorization processes.
  • Ability to manage both inbound and outbound call workflows while maintaining accuracy and quality.
  • Comfort working alongside AI-driven technology and contributing to its continuous improvement.
  • Strong organizational skills and the ability to manage detailed documentation across multiple systems.

Work Environment
This is a remote position based in the United States. Candidates must reside in one of the following states: Florida, North Carolina, Texas, Utah, South Carolina, Wisconsin, Georgia, Indiana, or Delaware. You will work in a virtual contact center environment focused on healthcare access and coordination, using AI-enabled tools to support agent-to-agent conversations. The role involves handling approximately 10-20 calls per day, with most calls lasting around 5 minutes and more complex insurance verification calls lasting 30-45 minutes. Specialists typically work on one AI-supported conversation at a time while ensuring all information is accurately captured and documented. You will regularly use multiple computer systems, screens, and applications, including Microsoft Office and internal platforms, to manage data entry, documentation, and call workflows. The environment emphasizes professionalism, attention to detail, and collaboration with AI technologies to create time for healthcare by improving access, adherence, and affordability.
Job Type & Location
This is a Contract to Hire position based out of Milwaukee, WI.
Pay and Benefits
The pay range for this position is $20.00 - $20.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
โ€ข Medical, dental & vision
โ€ข Critical Illness, Accident, and Hospital
โ€ข 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
โ€ข Life Insurance (Voluntary Life & AD&D for the employee and dependents)
โ€ข Short and long-term disability
โ€ข Health Spending Account (HSA)
โ€ข Transportation benefits
โ€ข Employee Assistance Program
โ€ข Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on Aug 21, 2026.
About Aston Carter
Aston Carter provides world-class corporate talent solutions to thousands of clients across the globe. Specialized in accounting, finance, human resources, talent acquisition, procurement, supply chain and select administrative professions, we extend the capabilities of industry-leading companies. We draw on our deep recruiting expertise and expansive network to meet the evolving needs of our clients and talent community with agility and excellence. With offices across the U.S., Canada, Asia Pacific and Europe, Aston Carter serves many of the Fortune 500. We are proud to be a ClearlyRated Best of Staffingยฎ Platinum Award winner for both client and talent service.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email astoncarteraccommodation@astoncarter.com for other accommodation options.
San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.
Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.

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About Aston Carter

Sourced by ZipRecruiter

At Aston Carter, we're dedicated to expanding career opportunities for the skilled professionals who power our business. Our success is driven by the talented, motivated people who join our team across a range of positions - from recruiting, sales and delivery to corporate roles. As part of our team, employees have the opportunity for long-term career success, where hard work is rewarded and the potential for growth is limitless. Established in 1997, Aston Carter is a leading staffing and consulting firm, providing high-caliber talent and premium services to more than 7,000 companies across North America. Spanning four continents and more than 200 offices, we extend our clients' capabilities by seeking solvers and delivering solutions to address today's workforce challenges. For organizations looking for innovative solutions shaped by critical-thinking professionals, visit AstonCarter.com. Aston Carter is a company within Allegis Group, a global leader in talent solutions.

Industry

Recruiting and staffing services

Company size

1,001 - 5,000 Employees

Headquarters location

Hanover, MA, US