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Remote Prior Authorization Nurse Jobs (NOW HIRING)

Managed Staffing

Licensed Vocational Nurse - LPN

RI · Remote

$28 - $30/hr

Licensed Vocational Nurse (LPN) - Remote Prior Authorization 100% Remote - Anywhere in the U.S. Schedule: Monday-Friday, Day Shift (No weekends unless overtime is required) About the Role We are ...

IVX Health

Prior Authorization Coordinator

Brentwood, TN · On-site +1

$17.50 - $21.75/hr

Fully Remote, Hybrid, or In-office (Brentwood, TN) * Schedule : Monday - Friday, standard business hours (no nights, weekends, or holidays) What You Will Do * Review and Process Prior Authorizations ...

IVX Health

Prior Authorization Coordinator

$19 - $23.50/hr

Fully Remote, Hybrid, or In-office (Brentwood, TN) * Schedule : Monday - Friday, standard business hours (no nights, weekends, or holidays) What You Will Do * Review and Process Prior Authorizations ...

CareMed Specialty Pharmacy

$23 - $25/hr

Pharmacy Prior Authorization Specialist - CareMed Specialty Pharmacy Buffalo, NY | Full-Time | ... Remote work possible after initial on-site training. Company Benefits * Medical; Dental; Vision ...

PainPoint

Prior Authorization Coordinator

Atlanta, GA · On-site +1

$19 - $21/hr

Prior Authorization Coordinator Full-Time | $19-21/hour | Monday-Friday | 8:00 AM-4:30 PM CST ... Remote About DxTx Pain & Spine At DxTx Pain & Spine, we're redefining how pain and spine practices ...

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How much do remote prior authorization nurse jobs pay per hour?

As of Aug 4, 2026, the average hourly pay for remote prior authorization nurse in the United States is $38.62, according to ZipRecruiter salary data. Most workers in this role earn between $29.57 and $43.27 per hour, depending on experience, location, and employer.

What is a remote prior authorization nurse?

A Remote Prior Authorization Nurse is a registered nurse (RN) or licensed practical nurse (LPN) who reviews medical insurance requests to determine if they meet coverage criteria. They work remotely to assess patient records, collaborate with healthcare providers, and communicate approval or denial decisions based on insurance guidelines. Their role helps ensure patients receive necessary treatments while managing costs for insurance companies. Strong clinical knowledge, attention to detail, and familiarity with insurance policies are essential for this position.

What are the key skills and qualifications needed to thrive as a remote prior authorization nurse?

To thrive as a Remote Prior Authorization Nurse, you need a current RN license, knowledge of medical terminology, and experience with insurance or utilization review processes. Familiarity with prior authorization software, electronic medical records (EMRs), and payer systems is typically required, along with certifications like CCM or CPUR as a plus. Strong attention to detail, organizational skills, and effective written communication are valuable soft skills for this role. These skills are crucial to ensure accurate and efficient authorization of healthcare services, reduce claim denials, and facilitate patient care in a remote setting.

What does a remote prior authorization nurse do?

A typical day for a Remote Prior Authorization Nurse involves reviewing medical records and provider documentation, communicating with physicians or healthcare providers to gather additional information, and submitting authorizations to insurance companies. You may spend much of your time using specialized software to track requests, document outcomes, and ensure compliance with payer guidelines. Collaboration is often required with case managers, providers, and insurance representatives to resolve questions and expedite approvals. While the work is primarily independent, staying organized and communicating effectively with the healthcare team are essential for success in this remote position.

More about Remote Prior Authorization Nurse jobs
What cities are hiring for Remote Prior Authorization Nurse jobs? Cities with the most Remote Prior Authorization Nurse job openings:
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Remote Prior Authorization Nurse jobs near you
Infographic showing various Remote Prior Authorization Nurse job openings in the United States as of July 2026, with employment types broken down into 70% Full Time, 20% Part Time, and 10% Contract. Highlights an 100% Remote job distribution, with an average salary of $80,321 per year, or $38.6 per hour.

REMOTE Prior Authorization Pharmacist

Insight Global

Philadelphia, PA • Remote

$58.50 - $59/hr

Contractor

Medical, Dental, Vision

Posted 12 days ago

Job description

The Pharmacist, Prior Authorization (PA) & Appeals, is responsible for reviewing and evaluating prior authorization and appeals requests to determine coverage based on clinical guidelines, pharmacy policies, and health plan benefits. In this fast-paced, high-volume environment, the pharmacist works closely with physicians, healthcare providers, pharmacy technicians, and internal teams to gather and assess clinical information, make evidence-based coverage determinations, recommend formulary-compliant and cost-effective treatment alternatives, and ensure compliance with federal and state regulations. The role requires strong clinical judgment, attention to detail, effective communication skills, and the ability to manage competing priorities while meeting productivity and quality standards. Additionally, the pharmacist supports quality assurance initiatives, resolves provider and pharmacy inquiries, participates in process improvement efforts, and contributes to a collaborative, customer-focused team environment. Maintain full compliance with state and federal pharmacy laws, Medicare Part D, Medicaid, and commercial benefit regulations. Accurately document case decisions in accordance with internal protocols, auditing standards, and confidentiality policies. Effectively manage case volume by organizing workload, setting daily priorities, and meeting productivity and quality benchmarks. Adapt to fluctuating demands while maintaining accuracy and professionalism under pressure.

  • Requirements:
    • Bachelor's or Doctorate of Pharmacy
    • Active State Pharmacist License / Current Licensed Pharmacist in state of work
    • 6+ months of customer service/customer relations experience with healthcare professionals
    • Basic proficiency with Microsoft Excel, Word, and Outlook
    • Comfortable working in a call center/production-based environment
    • Ability to work remotely with little to no supervision
    • Strong adaptability in a fast-paced, high-volume setting
  • Duration: 6-Month Contract
  • Location: Remote
  • Day-to-Day:
    • Review and evaluate prior authorization and appeal requests for pharmacy coverage determinations
    • Assess clinical information and apply pharmacy policies, clinical guidelines, and health plan benefits
    • Collaborate with physicians, healthcare providers, pharmacy technicians, and internal teams
    • Recommend formulary-compliant and cost-effective treatment alternatives
    • Ensure compliance with state and federal pharmacy regulations, Medicare Part D, Medicaid, and commercial benefit requirements
    • Manage a high-volume caseload while maintaining quality and productivity standards
    • Document case decisions and assist with quality assurance and process improvement initiatives