Jacksonville, FL · Remote
$26.41 - $51.49/hr
Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. Processes requests within required timelines. Refers appropriate cases to medical directors, and ...
Jacksonville, FL · Remote
$26.41 - $51.49/hr
Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. Processes requests within required timelines. Refers appropriate cases to medical directors, and ...
Miami, FL · Remote
$26.41 - $51.49/hr
Required Qualifications • At least 2 years experience in a hospital acute care, inpatient review, prior authorization, nursing, and/or managed care setting, or equivalent combination of relevant ...
Miami, FL · Remote
$26.41 - $51.49/hr
Required Qualifications • At least 2 years experience in a hospital acute care, inpatient review, prior authorization, nursing, and/or managed care setting, or equivalent combination of relevant ...
Jacksonville, FL · Remote
$26.41 - $43/hr
Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. Processes requests within required timelines. Refers appropriate cases to medical directors (MDs ...
Jacksonville, FL · Remote
$26.41 - $43/hr
Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. Processes requests within required timelines. Refers appropriate cases to medical directors (MDs ...
Miami, FL · Remote
$26.41 - $43/hr
Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. Processes requests within required timelines. Refers appropriate cases to medical directors (MDs ...
Miami, FL · Remote
$26.41 - $43/hr
Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. Processes requests within required timelines. Refers appropriate cases to medical directors (MDs ...
Miami, FL · Remote
$26.41 - $51.49/hr
Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. Processes requests within required timelines. Refers appropriate cases to medical directors, and ...
Miami, FL · Remote
$26.41 - $51.49/hr
Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. Processes requests within required timelines. Refers appropriate cases to medical directors, and ...
Saint Petersburg, FL · Remote
$26.41 - $51.49/hr
Required Qualifications • At least 2 years experience in a hospital acute care, inpatient review, prior authorization, nursing, and/or managed care setting, or equivalent combination of relevant ...
Saint Petersburg, FL · Remote
$26.41 - $51.49/hr
Required Qualifications • At least 2 years experience in a hospital acute care, inpatient review, prior authorization, nursing, and/or managed care setting, or equivalent combination of relevant ...
Orlando, FL · Remote
$26.41 - $51.49/hr
Required Qualifications • At least 2 years experience in a hospital acute care, inpatient review, prior authorization, nursing, and/or managed care setting, or equivalent combination of relevant ...
Orlando, FL · Remote
$26.41 - $51.49/hr
Required Qualifications • At least 2 years experience in a hospital acute care, inpatient review, prior authorization, nursing, and/or managed care setting, or equivalent combination of relevant ...
Tampa, FL · Remote
$26.41 - $51.49/hr
Required Qualifications • At least 2 years experience in a hospital acute care, inpatient review, prior authorization, nursing, and/or managed care setting, or equivalent combination of relevant ...
Tampa, FL · Remote
$26.41 - $51.49/hr
Required Qualifications • At least 2 years experience in a hospital acute care, inpatient review, prior authorization, nursing, and/or managed care setting, or equivalent combination of relevant ...
Miami, FL · Remote
$26.41 - $51.49/hr
Required Qualifications • At least 2 years experience in a hospital acute care, inpatient review, prior authorization, nursing, and/or managed care setting, or equivalent combination of relevant ...
Miami, FL · Remote
$26.41 - $51.49/hr
Required Qualifications • At least 2 years experience in a hospital acute care, inpatient review, prior authorization, nursing, and/or managed care setting, or equivalent combination of relevant ...
Fort Lauderdale, FL · Remote
$26.41 - $51.49/hr
Required Qualifications • At least 2 years experience in a hospital acute care, inpatient review, prior authorization, nursing, and/or managed care setting, or equivalent combination of relevant ...
Fort Lauderdale, FL · Remote
$26.41 - $51.49/hr
Required Qualifications • At least 2 years experience in a hospital acute care, inpatient review, prior authorization, nursing, and/or managed care setting, or equivalent combination of relevant ...
Jacksonville, FL · Remote
$26.41 - $51.49/hr
Required Qualifications • At least 2 years experience in a hospital acute care, inpatient review, prior authorization, nursing, and/or managed care setting, or equivalent combination of relevant ...
Jacksonville, FL · Remote
$26.41 - $51.49/hr
Required Qualifications • At least 2 years experience in a hospital acute care, inpatient review, prior authorization, nursing, and/or managed care setting, or equivalent combination of relevant ...
Miami, FL · Remote
$100 - $200/hr
Remote Job Overview We are seeking experienced AI Consulting Domain Experts to contribute their ... No prior AI experience is required--your consulting expertise, analytical thinking, and ...
Quick apply
Miami, FL · Remote
$100 - $200/hr
Remote Job Overview We are seeking experienced AI Consulting Domain Experts to contribute their ... No prior AI experience is required--your consulting expertise, analytical thinking, and ...
Medical
Life
Retirement
PTO
Remote - USA • What you'll do: End-to-End Technical Integration Delivery * Lead end-to-end design ... Revenue cycle systems, prior authorization systems * Proficient in configuring and troubleshooting ...
New
Medical
Life
Retirement
PTO
Remote - USA • What you'll do: End-to-End Technical Integration Delivery * Lead end-to-end design ... Revenue cycle systems, prior authorization systems * Proficient in configuring and troubleshooting ...
New
Orlando, FL · Remote
$55 - $65/hr
... Analysts (BCBAs) to provide top-tier remote clinical oversight, programming, and telehealth ... Ensure all clinical documentation, progress notes, and authorization reports meet rigorous ...
Quick apply
Orlando, FL · Remote
$55 - $65/hr
... Analysts (BCBAs) to provide top-tier remote clinical oversight, programming, and telehealth ... Ensure all clinical documentation, progress notes, and authorization reports meet rigorous ...
Tampa, FL · Remote
$55 - $65/hr
... Analysts (BCBAs) to provide top-tier remote clinical oversight, programming, and telehealth ... Ensure all clinical documentation, progress notes, and authorization reports meet rigorous ...
Quick apply
Tampa, FL · Remote
$55 - $65/hr
... Analysts (BCBAs) to provide top-tier remote clinical oversight, programming, and telehealth ... Ensure all clinical documentation, progress notes, and authorization reports meet rigorous ...
Jacksonville, FL · Remote
$17 - $22.75/hr
Medical
Dental
Vision
Retirement
PTO
This remote position requires the individual to live within a 2-hour radius of Jacksonville, FL ... Strong analytical, problem‑solving, and decision‑making skills * High level of organization ...
Jacksonville, FL · Remote
$17 - $22.75/hr
Medical
Dental
Vision
Retirement
PTO
This remote position requires the individual to live within a 2-hour radius of Jacksonville, FL ... Strong analytical, problem‑solving, and decision‑making skills * High level of organization ...
Tallahassee, FL · Remote
Medical
Dental
Vision
Life
Retirement
PTO
S. citizens are authorized to access information under this program/contract. Security Clearance ... SAP Knowledge, prior implementation experience. * Experience with agile frameworks/iterative ...
Tallahassee, FL · Remote
Medical
Dental
Vision
Life
Retirement
PTO
S. citizens are authorized to access information under this program/contract. Security Clearance ... SAP Knowledge, prior implementation experience. * Experience with agile frameworks/iterative ...
Melbourne, FL · Remote
$80K - $100K/yr
Medical
Dental
Vision
Retirement
This is a remote position. OCFO Financial Management Analyst - ESAG - Remote BizFirst is assisting ... Prior Space Force or Air Force comptroller (FM/CPTS) experience at the base, wing, or enterprise ...
Quick apply
Melbourne, FL · Remote
$80K - $100K/yr
Medical
Dental
Vision
Retirement
This is a remote position. OCFO Financial Management Analyst - ESAG - Remote BizFirst is assisting ... Prior Space Force or Air Force comptroller (FM/CPTS) experience at the base, wing, or enterprise ...
Lake Worth, FL · On-site +1
$15 - $18.75/hr
Medical
Dental
Vision
Retirement
Obtain, review and input insurance authorization and referrals prior to patient services, and ... Remote, hybrid, or onsite work options * Competitive compensation * Professional development ...
Lake Worth, FL · On-site +1
$15 - $18.75/hr
Medical
Dental
Vision
Retirement
Obtain, review and input insurance authorization and referrals prior to patient services, and ... Remote, hybrid, or onsite work options * Competitive compensation * Professional development ...
Miami, FL · Remote
$195K - $225K/yr
Location: Remote (United States) Type: Full-Time, Part-Time, or 1099 Compensation: $195,000-$255 ... Document thoroughly to support prior authorization and continuity of care What We Offer * Multi ...
New
Quick apply
Miami, FL · Remote
$195K - $225K/yr
Location: Remote (United States) Type: Full-Time, Part-Time, or 1099 Compensation: $195,000-$255 ... Document thoroughly to support prior authorization and continuity of care What We Offer * Multi ...
New
| Aspect | Remote Prior Authorization Analyst | Remote Claims Processor |
|---|---|---|
| Required Credentials | Healthcare certifications, knowledge of insurance policies | Basic insurance knowledge, data entry skills |
| Work Environment | Home office, healthcare or insurance companies | Home office, insurance companies or third-party administrators |
| Employer & Industry | Hospitals, insurance providers, healthcare organizations | Insurance companies, third-party claims firms |
| Common Search/Comparison | Yes | Yes |
The Remote Prior Authorization Analyst and Remote Claims Processor roles both operate in the healthcare insurance industry and often require knowledge of insurance policies. However, the analyst focuses on obtaining prior approvals for treatments, while the claims processor handles the processing of insurance claims after services are rendered. Both roles are typically remote, involve working within healthcare or insurance organizations, and are frequently compared by job seekers seeking similar positions in the industry.
The most popular types of Prior Authorization Analyst jobs in Florida are:
For Remote Prior Authorization Analyst jobs in Florida, the most frequently searched job titles are:
The top searched job categories for Remote Prior Authorization Analyst jobs in Florida are:
Cities in Florida with the most Remote Prior Authorization Analyst job openings:
Jacksonville, FL • Remote
$26.41 - $51.49/hr
Full-time
Posted 25 days ago
8.0
Based on 199 frontline employees who took The Breakroom Quiz
164th of 308 rated insurance
Job Summary
Provides support for member services review assessment activities for a specific area of specialty. Responsible for ensuring that services are medically necessary, align with established clinical guidelines, insurance policies, and regulations, and that members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. Must reside in Florida.
Essential Job Duties
Analyzes clinical service requests from members and providers against evidence-based clinical guidelines.
Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
Conducts reviews to determine prior authorization/financial responsibility for Molina and its members.
Processes requests within required timelines.
Refers appropriate cases to medical directors, and presents them in a consistent and efficient manner.
Requests additional information from members or providers as needed.
Makes member referrals to other clinical programs as appropriate.
Collaborates with multidisciplinary teams to promote the Molina care model.
Adheres to applicable utilization management policies and procedures.
Required Qualifications
At least 2 years experience in a hospital acute care, inpatient review, prior authorization, nursing, and/or managed care setting, or equivalent combination of relevant education and experience.
Occupational Therapist (OT), Physical Therapist (PT), Speech-Language Pathologist (SLP). License must be active and unrestricted in state of practice.
Ability to prioritize and manage multiple deadlines.
Excellent organizational, problem-solving and critical-thinking skills.
Excellent verbal and written communication skills.
Microsoft Office suite/applicable software program(s) proficiency.
#PJHS3
#LI-AC1
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $26.41 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Get the full story on Breakroom
Sourced by ZipRecruiter
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.
Health care and social assistance
10,000+ Employees
Long Beach, CA, US
1980
