Remote Prior Authorization Nurse Jobs in Renton, WA

Are you experienced in insurance verification, claim follow-up, and resolving payer issues? Do you thrive in fast-paced healthcare environments where attention to detail matters? Join GetixHealth as an Insurance Eligibility & Follow-Up Specialist and help ensure patients receive the coverage and care they need.

This role combines front-end insurance eligibility verification with back-end insurance follow-up responsibilities—helping reduce denials, improve reimbursement, and support a seamless patient financial experience from start to finish.

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Position: Full- Time

Potential Start Date: 5/26/2026

Location: Remote (Must pass an internet speed test/ we provide the equipment)

Compensation: $16- $18 per hour (based on experience) + quarterly bonus eligibility

Operational Hours: Operational hours: Monday–Friday, 10:00 AM – 10:00 PM EST (Must be flexible within business hours)

The Insurance Eligibility & Follow-Up Specialist is responsible for verifying patient insurance coverage prior to service, tracking outstanding insurance claims, resolving denials, and ensuring timely reimbursement from insurance carriers.

You’ll work closely with insurance companies, providers, patients, and internal teams to support both eligibility verification and accounts receivable follow-up functions.

Strong knowledge of insurance plans, claims management, and revenue cycle processes is essential.

• Follow-up with insurance companies on billed claims regarding claim status and resolution of payments in a timely manner.
• Verify patient insurance eligibility and benefits prior to scheduled services
• Confirm active coverage, copays, deductibles, coinsurance, and patient responsibility estimates
• Identify prior authorization requirements and escalate when needed
• Track outstanding insurance claims (Accounts Receivable / AR)
• Contact insurance companies by phone, payer portals, or email to check claim status
• Investigate denials, underpayments, rejections, and missing claim information
• Correct claim issues and resubmit claims when necessary
• Document all account activity and insurance updates accurately in the billing system
• Escalate complex or long-pending claims to supervisors or billing leadership
• Collaborate with scheduling, billing, and provider teams to prevent delays and claim denials
• Maintain compliance with HIPAA, payer guidelines, and internal policies
• Meet productivity, quality, and turnaround expectations in a high-volume environment
• Other duties as assigned
• *** Pay Range: $18 -$20 based on experience***

• High school diploma or GED required
• Bachelor’s degree preferred
• 2+ years of experience in insurance follow-up, eligibility verification, medical billing, or healthcare revenue cycle operations preferred
• Experience with AR follow-up, claims resolution, and payer portals required
• Experience working with Medicare, Medicaid, and commercial insurance plans preferred
• Strong understanding of insurance benefits, authorizations, and denial resolution
• Prior remote work experience preferred
• Strong verbal and written communication skills
• Proficiency in Microsoft Office and healthcare systems
• Experience with EHR systems and billing platforms preferredMust be able to type a minimum of 35 words per minute (WPM) with no more than 3 errors. A typing assessment will be administered during the interview process.

• Remote position requiring high-speed internet and a secure HIPAA-compliant workspace
• Prolonged sitting and regular computer use required
• Exposure to sensitive and confidential patient information
• Occasional overtime may be required based on workload and business demands 

• Comprehensive Health Benefits: Choose from a variety of medical, dental, and vision plans designed to support your overall well-being.
• Life & Disability Coverage: Receive company-paid Basic Life and AD&D insurance, short-term and long-term disability coverage, with the option to purchase additional voluntary Life and AD&D benefits.
• 401(k) Retirement Plan: Become eligible to participate in the company's 401(k) plan on the first day of the quarter following three months of continuous employment, with a company match to help you invest in your future.
• Paid Time Off: Begin accruing PTO on your first day of employment, promoting a healthy work-life balance from the start.
• Flexible Benefit Options: Tailor your benefits package with a variety of options to meet your individual and family needs.

Note: This job description outlines the primary duties and qualifications for the role. It is not intended to be an exhaustive list of responsibilities or working conditions. 

GetixHealth is an Equal Opportunity and E-Verify Employer!