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Remote Optum Prior Authorization Jobs in Rochester, MN

Solution Architect-Rev Cycle-Remote

Rochester, MN · On-site +1

$61.50 - $81/hr

... Prior Authorization (EMPA), and Real-Time Eligibility (RTE). In addition to core front-end ... This position is a 100% remote work. Individual may live anywhere in the US. **This vacancy is not ...

Solution Architect-Rev Cycle-Remote

Rochester, MN · On-site +1

$64 - $84.25/hr

... Prior Authorization (EMPA), and Real-Time Eligibility (RTE). In addition to core front-end ... This position is a 100% remote work. Individual may live anywhere in the US. **This vacancy is not ...

Solution Architect-Rev Cycle-Remote

Rochester, MN · On-site +1

$61.50 - $81/hr

... Prior Authorization (EMPA), and Real-Time Eligibility (RTE). In addition to core front-end ... This position is a 100% remote work. Individual may live anywhere in the US. **This vacancy is not ...

Solution Architect-Rev Cycle-Remote

Rochester, MN · On-site +1

$134.35K - $164.57K/yr

... Prior Authorization (EMPA), and Real-Time Eligibility (RTE). In addition to core front-end ... This position is a 100% remote work. Individual may live anywhere in the US. **This vacancy is not ...

Remote Optum Prior Authorization information

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 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 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 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:
Infographic showing various Remote Optum Prior Authorization job openings in Rochester, MN as of May 2026, with employment types broken down into 98% Full Time, 1% Contract, and 1% Nights. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution.
Solution Architect-Rev Cycle-Remote

Solution Architect-Rev Cycle-Remote

Mayo Clinic

Rochester, MN • On-site, Remote

$61.50 - $81/hr

Full-time

Medical, Dental, Vision, Retirement

Posted 29 days ago


Mayo Clinic rating

7.8

Company rating: 7.8 out of 10

Based on 672 frontline employees who took The Breakroom Quiz

130th of 864 rated healthcare providers


Job description

Job Description
Candidate highly skilled Epic professional holding multiple active certifications with a proven track record in the front-end access space. We are looking for an architect who brings deep configuration and workflow design expertise in Prelude, Referrals, Electronic Medical Prior Authorization (EMPA), and Real-Time Eligibility (RTE).
In addition to core front-end applications, preferred candidates will have experience optimizing the digital patient experience through Epic MyChart or a custom healthcare portal (portal-specific certification is not required). As a Solution Architect, this expertise will be leveraged to collaborate on integrated solutions that streamline patient access and enhance organizational efficiency.
Qualifications
Bachelor's degree and 8 years' experience including 5 years' of demonstrated technical experience and 3 years of demonstrated leadership experience.
Masters degree in applicable field preferred.
Multiple (three or more) Epic Certifications OR relevant Intelligent Automation/AI certifications required.
Healthcare Financial Management Association (HFMA) Certification Preferred.
Working knowledge of large language models, AI agents, and/or ML lifecycle management. Proven track record of designing enterprise-scale solutions using automation platforms (UiPath preferred).
Works cross functionally across Mayo Clinic Departments. Demonstrated project and deliverable consistency through repeatable and reliable performance. Demonstrates initiative and self-motivation to complete tasks and assignments on time. Proven evidence of project management skills. Demonstrated oral and written communication, organization, problem solving, and facilitation skills. Evidence of mastery level expertise in multiple technologies. Demonstrated ability in solving complex technical and application problems with multiple technologies. Experience working in healthcare technology and Epic. Exposure to managing both custom developed and vendor-supplied applications.
*This position is a 100% remote work. Individual may live anywhere in the US.
**This vacancy is not eligible for sponsorship / we will not sponsor or transfer visas for this position.
About Us
Why Mayo Clinic
Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans - to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic.
Benefits Highlights
  • Medical: Multiple plan options.
  • Dental: Delta Dental or reimbursement account for flexible coverage.
  • Vision: Affordable plan with national network.
  • Pre-Tax Savings: HSA and FSAs for eligible expenses.
  • Retirement: Competitive retirement package to secure your future.

About the Team
Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is.
Equal Opportunity
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the "EOE is the Law". Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.

What Mayo Clinic employees say

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Benefits

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Mayo Clinic logo

About Mayo Clinic

Sourced by ZipRecruiter

Mayo Clinic is the largest integrated, not-for-profit medical group practice in the world. We're building the future, one where the best possible care is available to everyone — and more people can heal at home. Our relentless research turns into earlier diagnoses and new cures. That's how we inspire hope in those who need it most. At Mayo Clinic, experts work together to solve the most challenging unmet needs of patients. Our history of innovation dates back almost 150 years, when brothers Will and Charlie Mayo pioneered an integrated, team-based approach to medicine. Today, that trailblazing spirit drives innovations like Mayo Clinic Platform — which powers new technologies to change how care is delivered to all.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Rochester, MN, US

Year founded

1919