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Remote Prior Authorization Analyst Jobs in Ohio (NOW HIRING)

Gifthealth Inc

Lead Reimbursement Analyst

Columbus, OH · Remote

$31.47 - $39.34/hr

... prior authorizations, appeals, and patient assistance programs; manage and resolve escalated cases ... Remote; desk-based role with frequent phone and computer use and minimal physical requirements

MCKESSON

Field Reimbursement Manager

Columbus, OH · On-site +1

... Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client ...

MCKESSON

Field Reimbursement Manager

Middletown, OH · On-site +1

... Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client ...

MCKESSON

Field Reimbursement Manager

Amherst, OH · On-site +1

... Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client ...

MCKESSON

Field Reimbursement Manager

Cleveland, OH · On-site +1

... Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client ...

MCKESSON

Field Reimbursement Manager

Springfield, OH · On-site +1

... Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client ...

CSAA

Regulatory Reporting Analyst- Remote

Delaware, OH · Remote

  • Retirement

Analyze regulatory data against statutory financial statements, prior regulatory filings, and other ... Applicants must have authorization to work indefinitely in the US. Please do not apply for this ...

McKesson Corporation

Sr. Product Manager

Columbus, OH · On-site +1

$119K - $198K/yr

Working knowledge of the prior authorization landscape, including payer workflows, clinical decision support, or healthcare interoperability (HL7, FHIR, SCRIPT). * Strong analytical skills ...

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Remote Prior Authorization Analyst information

What is the difference between Remote Prior Authorization Analyst vs Remote Claims Processor?

AspectRemote Prior Authorization AnalystRemote Claims Processor
Required CredentialsHealthcare certifications, knowledge of insurance policiesBasic insurance knowledge, data entry skills
Work EnvironmentHome office, healthcare or insurance companiesHome office, insurance companies or third-party administrators
Employer & IndustryHospitals, insurance providers, healthcare organizationsInsurance companies, third-party claims firms
Common Search/ComparisonYesYes

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.

What are the most commonly searched types of Prior Authorization Analyst jobs in Ohio?

The most popular types of Prior Authorization Analyst jobs in Ohio are:

What are popular job titles related to Remote Prior Authorization Analyst jobs in Ohio?

For Remote Prior Authorization Analyst jobs in Ohio, the most frequently searched job titles are:

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The top searched job categories for Remote Prior Authorization Analyst jobs in Ohio are:

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Cities in Ohio with the most Remote Prior Authorization Analyst job openings:

Remote Prior Authorization Analyst jobs near you

Pharmacy Prior Authorization Specialist

Communicarehealth

Broadview Heights, OH • Remote

$17.50 - $23.25/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 29 days ago

Job description

Job Address:

9299 Market Place Broadview Heights, OH 44147


Job Description: Prior Authorization Specialist

Reports to: Pharmacy Prior Authorization Manager

Job Type: Full-Time - Remote - Pharmacies: West Virginia, Ohio, Indiana and Maryland

Position Overview: The Prior Authorization Specialist will maintain the Prior Authorization's workflow for a set of facilities assigned by the supervisor, while providing customer service to clients. He/she wil enter required information and submit Prior Authorizations to the respective plan, follow the prior authorization to completion, identify and clarify any discrepancies with a prior authorization, and participate in the appeal process.

Key Responsibilities Include but are not limited to:

  • Work in cohesion with the Adjudication, Claim Intervention and Billing Departments
  • Submit prior authorizations in accordance with Insurance regulations
  • Ensure accurate and timely processing of prior authorizations
  • Work directly with insurance companies for prior authorization resolution
  • Communicate with facilities to gain additional information
  • Any other duties assigned
  • Follow federal and state regulations
  • Adhere to company policies and procedures
  • Follow HIPPA guidelines and regulations

Qualifications and Requirements:

  • Prior Authorization experience (not required)
  • Previous Long-Term Care pharmacy experience a plus (not required)
  • Knowledge of Framework LTC a plus (not required)

Salary and Benefits:

  • Competitive salary commensurate with experience
  • Comprehensive benefits package, including health, dental, and vision insurance, 401(k) with company match, paid time off, and more

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