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Remote Prior Authorization Analyst Jobs in Gilbert, AZ

A-Line Staffing Solutions

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Remote Pharmacist - Prior Authorization / PBM Experience

Phoenix, AZ · Remote

$53 - $55/hr

Pay: $53.00 per hour Remote Pharmacist - Prior Authorization / PBM Experience Pay Rate: $53.00/hr Start Dates * October 12th * October 26th Training Requirements * Mandatory paid training is held ...

MedImpact

Prior Authorization Coordinator I

Tempe, AZ · On-site +1

$22.55 - $27.41/hr

Uses various business applications to perform analysis, obtain information, and enter prior ... remote location with management approval based on business requirements). Must provide adequate ...

Onco360

Pharmacy Prior Authorization Specialist

Scottsdale, AZ · On-site +1

$20.75 - $26.75/hr

Remote work possible after initial on-site training. Why Join Us? * A career with purpose: Help ... Manage prior authorization requests and appeals with insurance carriers. * Collaborate with ...

American Vision Partners

EDI Analyst

Phoenix, AZ · Remote

... prior authorization transactions. The EDI Specialist works with claims and payment teams on the ... This position has the potential to be remote in the following states: Arizona, Nevada, California ...

American Vision Partners

EDI Analyst

Phoenix, AZ · Remote

... prior authorization transactions. The EDI Specialist works with claims and payment teams on the ... This position has the potential to be remote in the following states: Arizona, Nevada, California ...

American Vision Partners

EDI Analyst

Phoenix, AZ · Remote

... prior authorization transactions. The EDI Specialist works with claims and payment teams on the ... This position has the potential to be remote in the following states: Arizona, Nevada, California ...

Banner Health

RN Medical Management

Phoenix, AZ · Remote

Ideal candidates have experience in prior authorization or utilization management, experience using CareWebQI/InterQual, possess a strong clinical background, and are comfortable working in a remote ...

Valeris

Remote Field Reimbursement Manager

Phoenix, AZ · Remote

As a Remote Field Reimbursement Manager you will help support patient access to critical therapies ... prior authorizations, appeals processes, and patient support financial assistance offerings. This ...

The State of Arizona

CR EXECUTIVE DIRECTOR

Phoenix, AZ · On-site +1

$120K - $150K/yr

... remote work, should be performed within Arizona unless an exception is properly authorized in ... Such presentations shall be made available to the Council prior to dissemination. Director shall be ...

ConnectMed360

Oncology Case Manager

Scottsdale, AZ · On-site +1

$60K/yr

This position is Full-Time , Remote , working Monday - Friday starting out 9:30am to 6:00pm then ... Support the facilitation of prior authorization and appeal processes by gathering necessary ...

Armavel, LLC

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Cybersecurity Analyst - Mid (REMOTE)

Phoenix, AZ · Remote

$70K - $85K/yr

Experience analyzing authorization documents and associated artifacts against authorization ... Fully remote workforce - work from anywhere in the US! * You'll get lots of work done, and work ...

YO AI Labs

AI Consulting Expert - Remote

Phoenix, AZ · 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 ...

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All JobsPrior Authorization Analyst JobsRemote Prior Authorization Analyst JobsRemote Prior Authorization Analyst Jobs in Gilbert, AZ

Remote Prior Authorization Analyst information

See Gilbert, AZ salary details

$30.9K

$73K

$129.6K

How much do remote prior authorization analyst jobs pay per year?

As of Aug 24, 2026, the average yearly pay for remote prior authorization analyst in Gilbert, AZ is $73,027.00, according to ZipRecruiter salary data. Most workers in this role earn between $52,300.00 and $86,700.00 per year, depending on experience, location, and employer.

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 popular job titles related to Remote Prior Authorization Analyst jobs in Gilbert, AZ?

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

What job categories do people searching Remote Prior Authorization Analyst jobs in Gilbert, AZ look for?

The top searched job categories for Remote Prior Authorization Analyst jobs in Gilbert, AZ are:

What cities near Gilbert, AZ are hiring for Remote Prior Authorization Analyst jobs?

Cities near Gilbert, AZ with the most Remote Prior Authorization Analyst job openings:

Remote Prior Authorization Analyst jobs near you

Remote Pharmacist - Prior Authorization / PBM Experience

A-Line Staffing Solutions

Phoenix, AZ • Remote

$53 - $55/hr

Full-time

Medical, Dental, Vision, Life, Retirement

This job post has expired today. Applications are no longer accepted.

Job description

Pay: $53.00 per hour

Job description:

Remote Pharmacist – Prior Authorization / PBM Experience

Pay Rate: $53.00/hr

Start Dates

  • October 12th
  • October 26th

Training Requirements

  • Mandatory paid training is held Monday – Friday, 9:00 AM – 5:30 PM EST for approximately 8–10 weeks.
  • Attendance is mandatory during training. No planned vacation or scheduling conflicts are permitted during this period.
  • Candidates must be available for the entire training schedule before accepting the assignment.
  • Camera must remain on during all virtual training sessions, supervisor meetings, and team meetings.

Schedule

Business Hours:

  • Monday – Friday: 7:00 AM – 8:00 PM EST
  • Saturday & Sunday: 7:00 AM – 4:30 PM EST

Schedule Type: Set Rotation

After training, candidates will be assigned an 8-hour shift based on business needs, which will include either:

  • One weekend day each week, or
  • A rotating weekend schedule.

Job Summary

We are seeking a licensed Registered Pharmacist to support a high-volume, remote Prior Authorization and Coverage Determination team. This role is responsible for reviewing pharmacy benefit requests, interpreting clinical criteria, evaluating Medicare Part D coverage determinations, and ensuring accurate, timely decisions while maintaining compliance with regulatory requirements.

The ideal candidate has experience in Pharmacy Benefit Management (PBM), prior authorizations, managed care, or clinical pharmacy operations and thrives in a productivity-driven remote environment with strict turnaround times.

This is a Safety Sensitive position.

Key Responsibilities

  • Review and evaluate prior authorization and coverage determination requests.
  • Interpret Medicare Part D guidelines, formulary requirements, and clinical criteria.
  • Apply evidence-based clinical judgment using drug information resources and clinical compendia.
  • Ensure compliance with CMS regulations, plan policies, and pharmacy benefit guidelines.
  • Document case reviews accurately and maintain audit-ready records.
  • Manage a high-volume case queue while meeting quality and productivity standards.
  • Perform provider outreach as needed to obtain clinical information or clarify requests.
  • Navigate multiple applications simultaneously while documenting case activity.
  • Work independently in a fast-paced remote environment with minimal supervision.
  • Participate in virtual meetings, coaching sessions, and required training.

Required Qualifications

  • Active Registered Pharmacist (RPh) license in good standing in the state of residence.
  • Experience with:
  • Pharmacy Benefit Management (PBM)
  • Prior Authorizations
  • Coverage Determinations
  • Medicare Part D
  • Formulary management
  • Drug Utilization Review (DUR)
  • Strong understanding of CMS regulations and managed care pharmacy.
  • Excellent documentation and data entry skills.
  • Experience working in high-volume, productivity-driven environments.
  • Strong computer skills, including Microsoft Excel and Word.
  • Ability to navigate multiple computer applications using dual monitors.

Preferred Qualifications

  • Experience with provider outreach and clinical case review.
  • Retail pharmacy combined with managed care or PBM experience.
  • Knowledge of Microsoft Access, PowerPoint, and Visio.
  • Previous remote clinical review experience.

Remote Work Requirements

Candidates must have:

  • A dedicated, quiet workspace free from interruptions.
  • Wired high-speed internet with a minimum of:
  • 25 Mbps download
  • 5 Mbps upload
  • Dual-monitor capability.
  • Ability to remain seated and focused throughout the workday.

Additional Requirements

  • Virtual interviews are conducted through Microsoft Teams.
  • Candidates must be comfortable with extensive data entry, multitasking, and working independently while maintaining productivity standards.
  • Opportunity for full-time employment based on performance.

Benefits:

  • Dental insurance
  • Health insurance
  • Vision insurance
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About A-Line Staffing Solutions

Sourced by ZipRecruiter

A-Line Staffing Solutions is an established full-service recruiting and staffing provider that operates in the industry of human resources and recruitment. Based in Utica, Michigan, A-Line Staffing Solutions has been committed to its mission of providing innovative and effective workforce solutions since its foundation. The company specializes in providing high-quality staffing solutions for a range of disciplines, including Information Technology, Professional, Administrative, Healthcare, and more. A-Line prides itself on its ability to offer comprehensive and tailored staffing solutions in line with the varying needs of different businesses, which has played a crucial role in the company's growth and success.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Utica, MI, US

Year founded

2004

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