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 ...
Boca Raton, FL · On-site +1
$16.75 - $22.50/hr
Ensure all required elements are obtained prior to benefits investigation and authorization ... Location: Remote with limited travel to client locations, internal business meetings, and other ...
Boca Raton, FL · On-site +1
$16.75 - $22.50/hr
Ensure all required elements are obtained prior to benefits investigation and authorization ... Location: Remote with limited travel to client locations, internal business meetings, and other ...
Boca Raton, FL · On-site +1
$18.25 - $24.75/hr
The Billing Specialist works closely with intake, prior authorization, cash posting, accounts ... Ensure nursing, drug, supply, and administration services are billed appropriately. * Verify ...
Boca Raton, FL · On-site +1
$18.25 - $24.75/hr
The Billing Specialist works closely with intake, prior authorization, cash posting, accounts ... Ensure nursing, drug, supply, and administration services are billed appropriately. * Verify ...
Lake Worth, FL · On-site +1
$15 - $18.75/hr
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
Obtain, review and input insurance authorization and referrals prior to patient services, and ... Remote, hybrid, or onsite work options * Competitive compensation * Professional development ...
West Palm Beach, 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 ...
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West Palm Beach, 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
Fort Lauderdale, 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
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Fort Lauderdale, 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
Hollywood, FL · Remote
$20 - $28/hr
Manage prior authorizations for ABA therapy services * Handle Single Case Agreements (SCAs) and ... Hollywood, Florida (Remote) Minimum Years of Experience: 6 Level of Education: Bachelor's Degree ...
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Hollywood, FL · Remote
$20 - $28/hr
Manage prior authorizations for ABA therapy services * Handle Single Case Agreements (SCAs) and ... Hollywood, Florida (Remote) Minimum Years of Experience: 6 Level of Education: Bachelor's Degree ...
Remote Authorization Specialist Remote | Full-Time | 9a-5p Monday-Friday | $24-$26/hour About the ... Verify benefits and eligibility prior to admission and throughout treatment * Complete pre ...
Remote Authorization Specialist Remote | Full-Time | 9a-5p Monday-Friday | $24-$26/hour About the ... Verify benefits and eligibility prior to admission and throughout treatment * Complete pre ...
Boca Raton, FL · Remote
$180K - $215K/yr
Minimal administrative burden in a fully remote, outpatient model What your day-to-day practice ... authorized to work in the U.S. only after a job offer is accepted and Form I-9 is completed. For ...
Quick apply
Boca Raton, FL · Remote
$180K - $215K/yr
Minimal administrative burden in a fully remote, outpatient model What your day-to-day practice ... authorized to work in the U.S. only after a job offer is accepted and Form I-9 is completed. For ...
West Palm Beach, FL · Remote
$180K - $215K/yr
Minimal administrative burden in a fully remote, outpatient model What your day-to-day practice ... authorized to work in the U.S. only after a job offer is accepted and Form I-9 is completed. For ...
Quick apply
West Palm Beach, FL · Remote
$180K - $215K/yr
Minimal administrative burden in a fully remote, outpatient model What your day-to-day practice ... authorized to work in the U.S. only after a job offer is accepted and Form I-9 is completed. For ...
Fort Lauderdale, FL · Remote
$180K - $215K/yr
Minimal administrative burden in a fully remote, outpatient model What your day-to-day practice ... authorized to work in the U.S. only after a job offer is accepted and Form I-9 is completed. For ...
Quick apply
Fort Lauderdale, FL · Remote
$180K - $215K/yr
Minimal administrative burden in a fully remote, outpatient model What your day-to-day practice ... authorized to work in the U.S. only after a job offer is accepted and Form I-9 is completed. For ...
Fort Lauderdale, FL · On-site +1
Complete necessary payer paperwork, including prior authorization forms and manual billing. * Handle non-standard order entry situations as required. * Support training needs within the team.
Fort Lauderdale, FL · On-site +1
Complete necessary payer paperwork, including prior authorization forms and manual billing. * Handle non-standard order entry situations as required. * Support training needs within the team.
Fort Lauderdale, FL · On-site +1
Complete necessary payer paperwork, including prior authorization forms and manual billing. * Handle non-standard order entry situations as required. * Support training needs within the team.
Fort Lauderdale, FL · On-site +1
Complete necessary payer paperwork, including prior authorization forms and manual billing. * Handle non-standard order entry situations as required. * Support training needs within the team.
Sunrise, FL · On-site +1
$17 - $22.25/hr
Submit prior authorizations for State insurance * Interact with insurance company on daily basis, i.e., overrides, rejections, and insurance updates * Interact with client facilities staff, PDP ...
New
Sunrise, FL · On-site +1
$17 - $22.25/hr
Submit prior authorizations for State insurance * Interact with insurance company on daily basis, i.e., overrides, rejections, and insurance updates * Interact with client facilities staff, PDP ...
New
Fort Lauderdale, FL · Remote
$80K - $100K/yr
Fully Remote - Utilization Review Schedule: Full-Time, Monday-Friday Hours: Standard business hours Patient Volume: N/A Job Requirements: * Active RN license with Multi-State/Compact license required
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Fort Lauderdale, FL · Remote
$80K - $100K/yr
Fully Remote - Utilization Review Schedule: Full-Time, Monday-Friday Hours: Standard business hours Patient Volume: N/A Job Requirements: * Active RN license with Multi-State/Compact license required
... Psychiatric Mental Health Nurse Practitioners (PMHNP). In this remote, independent contract ... prior to the commencement of credentialing. * Technical proficiency in navigating remote health ...
Quick apply
... Psychiatric Mental Health Nurse Practitioners (PMHNP). In this remote, independent contract ... prior to the commencement of credentialing. * Technical proficiency in navigating remote health ...
... Psychiatric Mental Health Nurse Practitioners (PMHNP). In this remote, independent contract ... prior to the commencement of credentialing. * Technical proficiency in navigating remote health ...
Quick apply
... Psychiatric Mental Health Nurse Practitioners (PMHNP). In this remote, independent contract ... prior to the commencement of credentialing. * Technical proficiency in navigating remote health ...
... Psychiatric Mental Health Nurse Practitioners (PMHNP). In this remote, independent contract ... prior to the commencement of credentialing. * Technical proficiency in navigating remote health ...
... Psychiatric Mental Health Nurse Practitioners (PMHNP). In this remote, independent contract ... prior to the commencement of credentialing. * Technical proficiency in navigating remote health ...
... Psychiatric Mental Health Nurse Practitioners (PMHNP). In this remote, independent contract ... prior to the commencement of credentialing. * Technical proficiency in navigating remote health ...
Quick apply
... Psychiatric Mental Health Nurse Practitioners (PMHNP). In this remote, independent contract ... prior to the commencement of credentialing. * Technical proficiency in navigating remote health ...
... Psychiatric Mental Health Nurse Practitioners (PMHNP). In this remote, independent contract ... prior to the commencement of credentialing. * Technical proficiency in navigating remote health ...
Quick apply
... Psychiatric Mental Health Nurse Practitioners (PMHNP). In this remote, independent contract ... prior to the commencement of credentialing. * Technical proficiency in navigating remote health ...
$16.42 - $20.57
3% of jobs
$20.57 - $24.72
7% of jobs
$27.83 is the 25th percentile. Wages below this are outliers.
$24.72 - $28.87
20% of jobs
The median wage is $32.38 / hr.
$28.87 - $33.01
24% of jobs
$33.01 - $37.16
14% of jobs
$39.71 is the 75th percentile. Wages above this are outliers.
$37.16 - $41.31
11% of jobs
$41.31 - $45.46
7% of jobs
$45.46 - $49.61
5% of jobs
$49.61 - $53.75
3% of jobs
$53.75 - $57.90
3% of jobs
$57.90 - $62.05
2% of jobs
$16
$36
$62
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.
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.
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.
For Remote Prior Authorization Nurse jobs in Boca Raton, FL, the most frequently searched job titles are:
The top searched job categories for Remote Prior Authorization Nurse jobs in Boca Raton, FL are:
Cities near Boca Raton, FL with the most Remote Prior Authorization Nurse job openings:
Fort Lauderdale, FL • Remote
$26.41 - $51.49/hr
Full-time
Posted 5 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.
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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
