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Remote Prior Authorization Nurse Jobs (NOW HIRING)

Pacer Group

Prior Authorization Pharmacist (Remote)

$59.50 - $71.75/hr

Prior Authorization Pharmacist (Remote) Location: Remote (Must be able to work EST hours) Duration: 3 months Schedule: Monday - Friday | 10:00 AM - 6:30 PM EST Weekend Rotation: Possible Saturday ...

Sarahbush

RN Prior Authorization

$27.68/hr

Please ensure that you are logged into Workday and applying through the Jobs Hub before proceeding. RN Prior Authorization Prior Authorization RN is responsible to obtain prior authorization for ...

OU Medical Center

Prior Authorization Specialist II

$18.50 - $24.50/hr

Prior Authorization Specialist II Department: Pre-visit Services New to OU Health? Ask your ... Remote Eligibility: Candidates must reside and work full-time in OK before their first day of ...

ICONMA

Prior Authorization Clinician

... looking for a Prior Authorization Clinician for their Remote location. Responsibilities ... Provides guidance and coaching to other utilization review nurses and participate in the ...

Managed Staffing

Prior Authorization Techician

RI · Remote

$21 - $22/hr

Fully Remote (U.S. based) - West Coast candidates preferred Seeking Pharmacy Technician I (Prior Authorization) professionals to join their remote Caremark team. This role is responsible for ...

Sarah Bush Lincoln

RN Prior Authorization

$27.68/hr

Please ensure that you are logged into Workday and applying through the Jobs Hub before proceeding. RN Prior Authorization Prior Authorization RN is responsible to obtain prior authorization for ...

OU Health

Prior Authorization Specialist II

$18.50 - $24.50/hr

Prior Authorization Specialist II Department: Pre-visit Services New to OU Health? Ask your ... Remote Eligibility: Candidates must reside and work full-time in OK before their first day of ...

OU Health

Prior Authorization Specialist II

$18.50 - $24.50/hr

Prior Authorization Specialist II Department: Pre-visit Services New to OU Health? Ask your ... Remote Eligibility: Candidates must reside and work full-time in OK before their first day of ...

Boston Medical Center

Prior Authorization Specialist I

$18.50 - $24.50/hr

Prior Authorization Specialist I Department: Patient Access Services Schedule: Full Time; 40-hours ... This is a Remote Position. JOB REQUIREMENTS EDUCATION : * High school diploma or GED required.

A-Line Staffing Solutions

Be Seen First

REMOTE Pharmacy Technician - Prior Authorization

Dallas, TX · Remote

$20/hr

Pharmacy Technician - Prior Authorization | Fully Remote Job Type: Full-Time Location: Fully Remote Pay: $20.00 per hour Schedule: Monday-Friday, between 8:00 AM and 8:00 PM Training Schedule: Monday ...

BMC Software

Prior Authorization Specialist I

$18.50 - $24.50/hr

Prior Authorization Specialist I This position can support Boston Medical Center Heath System ... This is a Remote Position. JOB REQUIREMENTS EDUCATION: * High school diploma or GED required.

MRIoA

Prior Authorization Pharmacist (Remote)

Salt Lake City, UT · On-site +1

$56.25 - $67.75/hr

An award-winning remote work environment POSITION OVERVIEW The PA Pharmacist is an important member ... To evaluate prior authorizations for drug appropriateness per drug policy criteria * To provide ...

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

As of Sep 14, 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 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.

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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 September 2026, with employment types broken down into 1% As Needed, 77% Full Time, 19% Part Time, 1% Temporary, and 2% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $80,321 per year, or $38.6 per hour.

Pharmacy Prior Authorization Specialist

Broadview Heights, OH • Remote

Communicarehealth
Health Care and Social Assistance • 10K+ employees
Learn more about Communicarehealthexternal

$17.50 - $23.25/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 13 hours ago

Communicare Health Services rating

6.1

Company rating: 6.1 out of 10

Based on 158 frontline employees who took The Breakroom Quiz

Job description

Job Address:

9299 Market Place Broadview Heights, OH 44147


Job Description: Prior Authorization Specialist

Reports to: Pharmacy Prior Authorization Manager

Job Type: Full-Time - Remote - Pharmacies: West Virginia, Ohio, Indiana and Maryland

Position Overview: The Prior Authorization Specialist will maintain the Prior Authorization's workflow for a set of facilities assigned by the supervisor, while providing customer service to clients. He/she wil enter required information and submit Prior Authorizations to the respective plan, follow the prior authorization to completion, identify and clarify any discrepancies with a prior authorization, and participate in the appeal process.

Key Responsibilities Include but are not limited to:

  • Work in cohesion with the Adjudication, Claim Intervention and Billing Departments
  • Submit prior authorizations in accordance with Insurance regulations
  • Ensure accurate and timely processing of prior authorizations
  • Work directly with insurance companies for prior authorization resolution
  • Communicate with facilities to gain additional information
  • Any other duties assigned
  • Follow federal and state regulations
  • Adhere to company policies and procedures
  • Follow HIPPA guidelines and regulations

Qualifications and Requirements:

  • Prior Authorization experience (not required)
  • Previous Long-Term Care pharmacy experience a plus (not required)
  • Knowledge of Framework LTC a plus (not required)

Salary and Benefits:

  • Competitive salary commensurate with experience
  • Comprehensive benefits package, including health, dental, and vision insurance, 401(k) with company match, paid time off, and more

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