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Remote Prior Authorization Rn Jobs in North Carolina

Sagility

RN Utilization Management Reviewer

Concord, NC · Remote

$35 - $40/hr

Conducts timely clinical decision review for services requiring prior authorization in a variety of ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

Sagility

RN Utilization Management Reviewer

Concord, NC · Remote

$35 - $40/hr

Conducts timely clinical decision review for services requiring prior authorization in a variety of ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

Sagility LLC

RN Utilization Management Reviewer

Concord, NC · Remote

$35 - $40/hr

Conducts timely clinical decision review for services requiring prior authorization in a variety of ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

Sagility LLC

RN Utilization Management Reviewer

Concord, NC · Remote

$35 - $40/hr

Conducts timely clinical decision review for services requiring prior authorization in a variety of ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

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Remote Prior Authorization Rn information

What is the difference between Remote Prior Authorization Rn vs Remote Medical Coder?

AspectRemote Prior Authorization RnRemote Medical Coder
CredentialsRN license, certification in case management or utilization reviewCertification in coding (CPC, CCS), high school diploma or equivalent
Work EnvironmentHealthcare facilities, insurance companies, telehealthMedical offices, insurance companies, remote coding platforms
Industry UsageUtilization review, patient authorization, insurance approvalMedical record review, billing, coding for insurance claims

Remote Prior Authorization Rns focus on reviewing patient information to approve treatments, while Remote Medical Coders translate medical records into codes for billing. Both roles require healthcare knowledge but serve different functions within the healthcare industry.

What are popular job titles related to Remote Prior Authorization Rn jobs in North Carolina?

For Remote Prior Authorization Rn jobs in North Carolina, the most frequently searched job titles are:

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The top searched job categories for Remote Prior Authorization Rn jobs in North Carolina are:

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Cities in North Carolina with the most Remote Prior Authorization Rn job openings:

Remote Prior Authorization Rn jobs near you
Infographic showing various Remote Prior Authorization Rn job openings in North Carolina as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 14% Part Time, 7% Temporary, and 2% Contract. Highlights an 93% Physical, 1% Hybrid, and 6% Remote job distribution.

Ambulatory Nurse - RN (FT or PT - Remote Options Available)

Rural Health Group, Inc.

Henderson, NC • On-site, Remote

Full-time, Part-time

Re-posted 4 days ago

Job description

**EXTERNAL CANDIDATES ONLY**
Rural Health Group, a Federally Qualified Health Center in northeastern North Carolina, is seeking a Registered Nurse (RN) to fill a full-time or part-time position (20 hours per week) as an Ambulatory Nurse in our Henderson location. Remote options are also available.
The Ambulatory Nurse is responsible for supporting patient care through the efficient management of clinical documentation, laboratory results, medication refill requests, patient communications, prior authorization coordination, and document management. This role serves as a key liaison between patients, providers, pharmacies, insurance companies, and other healthcare team members to ensure timely, accurate, and compassionate care while supporting and coordinating care for multiple providers within the practice.
A primary goal of this position is to reduce provider inbox burden by independently managing appropriate clinical workflows, coordinating patient care, and resolving complex clinical and administrative issues within established protocols. This position is not intended to function as an additional clinical assistant but rather as a licensed clinical resource that improves provider efficiency and continuity of patient care.
Essential duties and responsibilities include but are not limited to:
  • Respond to incoming patient phone calls, portal messages, and clinical inquiries.
  • Assess patient concerns and route urgent issues to the appropriate provider.
  • Provide patient education regarding medications, treatment plans, and follow-up care.
  • Document all patient interactions accurately in the electronic health record (EHR).
  • Process prescription refill requests according to established protocols.
  • Review refill eligibility, medication history, and provider instructions.
  • Coordinate with pharmacies regarding prescription clarifications.
  • Investigate and resolve medication access issues, including prior authorization barriers, insurance denials, formulary restrictions, and unavailable medications.
  • Review incoming laboratory and diagnostic reports.
  • Communicate normal and provider-reviewed results to patients.
  • Coordinate follow-up testing and appointments when indicated.
  • Track outstanding results and ensure provider review.
  • Maintain a tracking system for high-risk and abnormal test results, ensuring timely follow-up, provider escalation, patient communication, and documentation of outcomes.
  • Manage and maintain patient records within the EHR system.
  • Complete clinical forms and medical documentation.
  • Support providers with patient care coordination and workflow management.
  • Monitor patient follow-up needs and identify care gaps.

Successful candidate must demonstrate the Rural Health Group Core Competencies, which include:
  1. Good Judgment
  2. Communication/Customer Service/Teamwork
  3. Passion
  4. Honesty
  5. Responsibility
  6. Job-Specific Skill Set

Education, Licensure & Experience:
  • Current NC Registered Nurse (RN) licensure in good standing is required
  • Minimum two (2) years of experience as nurse, in outpatient, community/health, critical care or emergency care
  • Experience using electronic health records (EHR). Must be able to quickly learn to use eClinicalWorks electronic health record system
  • Experience with care coordination for the following populations is preferred: uninsured or underserved patients and patients with substance abuse disorders.
  • Experience in primary care, family practice, occupational health or ambulatory care preferred.
  • Strong communication, organizational, and problem-solving skills is required.
  • Ability to manage multiple priorities in a fast-paced environment is required.
  • Demonstrated ability to work independently with minimal supervision while exercising sound clinical judgment and adhering to established protocols, policies, and regulatory requirements is required.
  • Bilingual (English/Spanish) is a plus, but not required; applicants who may serve in a translating capacity will be required to take a language assessment

EOE. Federal and State Criminal Background Checks and Drug Screen required for all positions. Influenza vaccine is also a condition of employment.
E-Verify Notice: After accepting employment, new hires are required to complete an I-9 form and present documentation of their identity and eligibility to work in the United States.

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