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Remote Optum Prior Authorization Jobs (NOW HIRING)

OU Medical Center

Prior Authorization Specialist II

$18.50 - $24.50/hr

Prior Authorization Specialist II Department: Pre-visit Services New to OU Health? Ask your ... Remote Eligibility: Candidates must reside and work full-time in OK before their first day of ...

Managed Staffing

Prior Authorization Techician

RI · Remote

$21 - $22/hr

Fully Remote (U.S. based) - West Coast candidates preferred Seeking Pharmacy Technician I (Prior Authorization) professionals to join their remote Caremark team. This role is responsible for ...

OU Health

Prior Authorization Specialist II

$18.50 - $24.50/hr

Prior Authorization Specialist II Department: Pre-visit Services New to OU Health? Ask your ... Remote Eligibility: Candidates must reside and work full-time in OK before their first day of ...

MRIoA

Prior Authorization Pharmacist (Remote)

Salt Lake City, UT · On-site +1

$56.25 - $67.75/hr

An award-winning remote work environment POSITION OVERVIEW The PA Pharmacist is an important member ... To evaluate prior authorizations for drug appropriateness per drug policy criteria * To provide ...

Boston Medical Center

Prior Authorization Specialist I

$18.50 - $24.50/hr

Prior Authorization Specialist I Department: Patient Access Services Schedule: Full Time; 40-hours ... This is a Remote Position. JOB REQUIREMENTS EDUCATION : * High school diploma or GED required.

New

OU Health

Prior Authorization Specialist II

$18.50 - $24.50/hr

Prior Authorization Specialist II Department: Pre-visit Services New to OU Health? Ask your ... Remote Eligibility: Candidates must reside and work full-time in OK before their first day of ...

BMC Software

Prior Authorization Specialist I

$18.50 - $24.50/hr

Prior Authorization Specialist I This position can support Boston Medical Center Heath System ... This is a Remote Position. JOB REQUIREMENTS EDUCATION: * High school diploma or GED required.

New

MRIoA

Prior Authorization Pharmacist (Remote)

$59.50 - $71.75/hr

An award-winning remote work environment POSITION OVERVIEW The PA Pharmacist is an important member ... To evaluate prior authorizations for drug appropriateness per drug policy criteria * To provide ...

A-Line Staffing Solutions

Be Seen First

REMOTE Pharmacy Technician - Prior Authorization

Dallas, TX · Remote

$20/hr

Pharmacy Technician - Prior Authorization | Fully Remote Job Type: Full-Time Location: Fully Remote Pay: $20.00 per hour Schedule: Monday-Friday, between 8:00 AM and 8:00 PM Training Schedule: Monday ...

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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.

More about Remote Optum Prior Authorization jobs

What cities are hiring for Remote Optum Prior Authorization jobs?

Cities with the most Remote Optum Prior Authorization job openings:

What are the most commonly searched types of Optum Prior Authorization jobs?

The most popular types of Optum Prior Authorization jobs are:

What states have the most Remote Optum Prior Authorization jobs?

States with the most job openings for Remote Optum Prior Authorization jobs include:

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

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

Remote Optum Prior Authorization jobs near you
Infographic showing various Remote Optum Prior Authorization job openings in the United States as of September 2026, with employment types broken down into 73% Full Time, 9% Part Time, and 18% Contract. Highlights an 100% Remote job distribution.

Prior Authorization Specialist II

Remote

OU Medical Center
1 - 5K employees
Learn more about OU Medical Centerexternal

$18.50 - $24.50/hr

Full-time

Medical, Dental, Retirement, PTO

Posted 22 days ago

Job description

Position Title:Prior Authorization Specialist IIDepartment:Pre-visit ServicesJob Description:

New to OU Health? Ask your recruiter about our competitive wages and total rewards package.

Remote Eligibility: Candidates must reside and work full-time in OK before their first day of employment.

SHIFT: M-F, Days. Will need to be on-site as needed, at least monthly.

**Ideal candidate will have experience in pre-visit services for multiple areas, working with authorizations.**

General Description

Under general supervision, the Prior Authorization Specialist II effectively manages complex authorizations across multiple payers and specialties.

Essential Job Duties

Responsibilities listed in this section are core to the position. Inability to perform these responsibilities, with or without an accommodation, may result in disqualification from the position.

  • Independently manage complex and specialtyspecific authorization requests.

  • Interpret payer medical policies andutilizationmanagementcriteria.

  • Resolveauthorizationdenials and incomplete determinations.

  • Coordinate with clinical teams to obtain medical necessity documentation.

General Job Duties

  • Performs other duties as assigned

Minimum Requirements

Education: High School Diploma or GED required.

Experience: At least 3 years of prior authorization experience required.

Certification/License/Registration: CHAA or PACS required after 1 year.

Knowledge, Skills & Abilities

  • Appliedexpertisein payer medical policy interpretation.

  • Strong knowledge of specialtydriven authorization requirements.

  • Ability to analyze denial trends and recommend corrective actions.

  • Excellent written and verbal communication skills.

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Current OU Health Employees - Please click HERE to login.OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family.

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