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Remote Optum Prior Authorization Jobs in Rochester, MN

Mayo Clinic

Senior Specialist HIMS

Rochester, MN · On-site +1

Prefer that the candidate has prior ROI experience and customer service experience. Supports ... This is a hybrid position that is primarily remote. Candidates must reside within 100 miles of a ...

Mayo Clinic

Specialist-HIMS

Rochester, MN · On-site +1

$16.50 - $21.75/hr

... authorizations, requesting historical medical records, and preparing correspondence in response to ... Prefer that the candidate has prior ROI experience and customer service experience. Analyzes ...

All JobsOptum Prior Authorization JobsRemote Optum Prior Authorization JobsRemote Optum Prior Authorization Jobs in Rochester, MN

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 job?

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 are popular job titles related to Remote Optum Prior Authorization jobs in Rochester, MN? For Remote Optum Prior Authorization jobs in Rochester, MN, the most frequently searched job titles are:
What job categories do people searching Remote Optum Prior Authorization jobs in Rochester, MN look for? The top searched job categories for Remote Optum Prior Authorization jobs in Rochester, MN are:
What cities near Rochester, MN are hiring for Remote Optum Prior Authorization jobs? Cities near Rochester, MN 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 Rochester, MN as of July 2026, with employment types broken down into 1% As Needed, 87% Full Time, 11% Part Time, and 1% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution.
Member Care Champion / Medical Assistant (Rochester, MN)

Member Care Champion / Medical Assistant (Rochester, MN)

Enara Health

Rochester, MN • On-site, Remote

$19 - $21/hr

Part-time

Re-posted 14 days ago

Job description

About Enara
Enara is a world renowned obesity and medical weight loss start-up, based in Silicon Valley, pioneering the use of data, digital, and clinical treatments to provide personalized plans with measurable results. Enara was founded by people from Stanford, UCSF, Kaiser, ClassPass & Evernote. Our mission is to develop the first ever platform to scale obesity treatment. Our platform allows for the latest breakthroughs in nutrition, exercise, and obesity science to be optimized and delivered in a series of personalized and programmable experiences. Our solutions are disseminated through unified products and services we deploy for the healthcare ecosystem; with a current focus on small to medium sized medical groups and clinics. Our platform has served over 14,000 members and delivers world leading 16%+ weight loss sustained over 3 years. We deliver life changing care to members and we are redesigning the clinic-patient relationship. We are backed by Offline.VC, Charge.VC, VSC, Continuum Ventures, as well as many prominent angels in Silicon Valley.
 
Role
The Member Care Champion is an essential member of the clinical operations team at Enara Health. The ideal candidate will be responsible for overseeing several components of our member journey delivering quality patient care in every step of the way. You will work closely with the clinical and acquisition team performing various tasks that will ensure smooth member flow and efficient operation while streamlining the communication in between departments. We are looking for a warm, passionate team player to join this team to support our physicians, clinical staff and most importantly our members. The MCC will be responsible for adhering to all procedures and practice guidelines promoting communication with all team members, maintaining complete, timely and accurate clinical documentation on site but also online.
Key Responsibilities
  • Check-in Process: Be the friendly face that greets our members, manage the check-in process efficiently, measure and record vital signs accurately, and communicate effectively with our providers.
  • Perform Diagnostic Procedures: Conduct non-invasive diagnostic procedures like body measurements, body composition testing, metabolic testing, and EKGs, all while ensuring accuracy and compliance.
  • Schedule Follow-Up Appointments: Coordinate follow-up appointments, reach out to members who missed their appointments, and assist with rescheduling to keep everything on track.
  • New Member Enrollments: Assist with the onboarding process, including verifying member eligibility, confirming necessary information, and scheduling initial appointments.
  • Provide remote support to our Member Care & Growth Managers (Acquisitions team) by performing lead outreach and following up with missed initials to reschedule them.
  • Manage Inbound/Outbound Communications: Handle phone calls, voicemails, emails, and member app messages with patience and a smile, providing timely and accurate responses.
  • Cross-Department Coordination: Collaborate with other departments to address member concerns and ensure comprehensive and effective solutions.
  • Billing Coordination: Work closely with our billing partners to ensure prior authorization tasks are created and not missed, facilitating smooth processing of member enrollments and services.
  • Lead Outreach: Provide remote support to our acquisitions team by performing lead outreach and follow-up with missed initial appointments, ensuring a seamless enrollment process.
Skills and Attributes
  • Empathy and Professionalism: Understand members' needs and respond with empathy and professionalism.
  • Communication: Showcase excellent written and verbal communication skills for clear and effective interactions.
  • Adaptability: Be flexible and open to change in the fast-paced healthcare environment.
  • Problem-Solving: Think quickly to provide solutions to member issues, ensuring a seamless experience.
  • Team Collaboration: Work harmoniously with other departments to offer comprehensive support and care.
  • Promote Enara's Values: Model a compassionate, honest, positive, and open attitude. Use your communication skills to motivate, empower, and inspire others, contributing to our vibrant Enara culture.
Minimum Requirements
  • Minimum of 1 year related work experience in healthcare.
  • Proficiency in Google Suite (Documents, Sheets, Forms).
  • Proficiency with medical technology, including EMR and mobile apps.
  • Must live within commuting distance to Rochester, MN
Impress Us Even More
  • Passionate about Obesity Medicine, nutrition, fitness, behavioral health
$19 - $21 an hour
Job Type: Part-time, hybrid (approx 15-20 hours a week)
 
Job Location: Rochester, MN
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
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