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Remote Prior Authorization Nurse Jobs in Raleigh, NC

C4 Technical Services

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Member Services Specialist - Remote

Raleigh, NC · Remote

$18/hr

Must be authorized to work in the United States without current or future sponsorship requirements ... Prior remote/work-from-home experience. Physical Requirements * Ability to remain seated for ...

Valeris

Executive Case Manager (Remote)

Raleigh, NC · Remote

This includes completing benefit investigations, tracking prior authorizations / denial appeals ... Coordinates nurse teach with nurse educators, as applicable to program. * Supports adherence ...

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Remote Prior Authorization Nurse information

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$16

$37

$63

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

As of Sep 4, 2026, the average hourly pay for remote prior authorization nurse in Raleigh, NC is $37.54, according to ZipRecruiter salary data. Most workers in this role earn between $28.75 and $42.07 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 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.

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 are the most commonly searched types of Prior Authorization Nurse jobs in Raleigh, NC?

The most popular types of Prior Authorization Nurse jobs in Raleigh, NC are:

What are popular job titles related to Remote Prior Authorization Nurse jobs in Raleigh, NC?

For Remote Prior Authorization Nurse jobs in Raleigh, NC, the most frequently searched job titles are:

What job categories do people searching Remote Prior Authorization Nurse jobs in Raleigh, NC look for?

The top searched job categories for Remote Prior Authorization Nurse jobs in Raleigh, NC are:

What cities near Raleigh, NC are hiring for Remote Prior Authorization Nurse jobs?

Cities near Raleigh, NC with the most Remote Prior Authorization Nurse job openings:

Remote Prior Authorization Nurse jobs near you
Infographic showing various Remote Prior Authorization Nurse job openings in Raleigh, NC as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 18% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $78,079 per year, or $37.5 per hour.

Care Manager - Patient Support Call Center -Remote

IQVIA

Durham, NC • Remote

$22 - $23/hr

Full-time

Posted 3 days ago

New

IQVIA rating

8.1

Company rating: 8.1 out of 10

Based on 53 frontline employees who took The Breakroom Quiz

62nd of 226 rated it services

Job description

**This is posted in anticipation of a future role**

Position Summary:

Care Managers are responsible for contacting insurance companies to obtain correct eligibility information, perform benefit investigations, copay assistance and check prior authorization and/ or appeal status.

The information contained herein is intended to be an accurate reflection of the duties and responsibilities of the individuals assigned to this position. They are not intended to be an exhaustive list of the skills and abilities required to do the job. IQVIA reserves the right to revise the job or to require that other or different tasks be performed as assigned.

Care Manager

As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams help biopharma gettheir medicinestothe people who need them. We help customers gain insight and access to their markets andultimately demonstratetheirproduct'svalue to payers,physiciansand patients. A significant part of our business is acting as thebiopharma'ssales forcetophysicians or providing nurses to educate patients or prescribers. With the right experience, you can help deliver medical breakthroughs in the real world.

Position Summary:

Responsibilities will vary by program and its lifecycle. Care Manager's maybe responsible forcontacting insurance companies to obtain correct eligibility information, perform benefit investigations, copayassistanceand check prior authorization and/or appeal status. Care Managers may alsobe responsible fordirectly contacting patients and/or providers to evaluate eligibility forassistanceprograms and/or variedadherencesupport. This is aremoteposition.

Job Responsibilities:

  • Perform outbound calls to obtainappropriate informationanddocumentaccurately.

  • Responsible for answering in-bound calls andassistingcustomers withpharmacy relatedservices.

  • Maintain strict professionalism in all communication methods while providing efficient, courteous, and friendly service.

  • Contact insurance companies for benefit investigation and coverage eligibility.

  • Provide prior authorizations and appeals support.

  • Assistpatients with the enrollment process for manufacturer and non-profitorganizationcopayassistanceprograms.

  • Update job knowledge byparticipatingin educational opportunities and training activities. Work efficiently both individually and within a team toaccomplishrequired tasks.

  • Maintain and improve quality results by adhering to standards and guidelines by meeting quality standards set forth by program KPI's.

  • Report ADE's according to program policy and guidelinesAdhereto all HIPAA guidelines Mayassistwith onboarding new employees.

Schedule:

  • Must be available for an8 hourshift between 8am-8pm EST

RequiredQualifications:

  • High School Diploma or equivalent

  • Minimum oneyearexperience in medical billing, reimbursement, insurance verification, or similar related medical office experience.

  • Previousdata entry experience (minimum three months) and ability to type 30wpm+.

  • Able todemonstratehigh attention to detail in work.

  • Mustbe computer savvy,to includenavigating multiple computer tabs,monitors,and applications.

  • Advanced ability/knowledge of all Microsoft Suite programs (Teams, Word, Excel, Outlook,etc.) and soft phone systems (WebEx, Mitel,Shoretel, etc.).

  • Exceptional communication skills, both written and verbal.

  • Able to work in a virtual team environment by being available and responsive during working hours.

  • Excellent follow through This is a remote position.

  • Employees must have a private workspace free of distraction to adhere to HIPAA compliance/guidelines.

  • Workspace must include internet plug-in accessibility. Wi-fi connectivity is notpermitted.

  • Mustresidein country wherethe jobis posted.

Preferred Qualifications:

  • Some College.

  • Bilingual Spanish - English

  • Previousexperience in Patient Support Services (Hub).

  • PreviousCustomer Service experience in the healthcare field.

#LI-CES

#LI-DNP

IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more athttps://jobs.iqvia.com

IQVIA is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable law. https://jobs.iqvia.com/eoe

IQVIA is committed to integrity in our hiring process and maintains a zero tolerance policy for candidate fraud. All information and credentials submitted in your application must be truthful and complete. Any false statements, misrepresentations, or material omissions during the recruitment process will result in immediate disqualification of your application, or termination of employment if discovered later, in accordance with applicable law. We appreciate your honesty and professionalism.

The potential base pay range for this role is $22.00 - $23.00 per hour. The actual base pay offered may vary based on a number of factors including job-related qualifications such as knowledge, skills, education, and experience; location; and/or schedule (full or part-time). Dependent on the position offered, incentive plans, bonuses, and/or other forms of compensation may be offered, in addition to a range of health and welfare and/or other benefits.

What IQVIA employees say

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About IQVIA

Sourced by ZipRecruiter

At IQVIA, we are passionate about helping customers and partners improve results and patient outcomes. Everything we do contributes to this vision for creating a healthier world. In today’s healthcare environment, it’s not only about how much data, information, and technology you have at your fingertips – it’s what you do with it. IQVIA is focused on making intelligent connections for customers across the entire healthcare ecosystem to help you drive healthcare forward. Whether that means partnering with novel technology companies to boost patient engagement, leveraging AI & machine learning to accelerate results, or using decentralized trials to reach the right patients wherever they are – we are always looking for smarter ways to move you forward.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Durham, NC, US

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