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Remote Prior Authorization Rn Jobs in Boca Raton, FL

SPECIALTY RX, Inc.

Billing Representative- Remote

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 ...

Seaside Home Health

Clinical Manager

Delray Beach, FL · Remote

The Part-Time QA Nurse is a remote-based RN who plays a critical role in ensuring the clinical documentation integrity, regulatory compliance, and accreditation readiness of our Florida-based home ...

Scribe-X

Remote Medical Scribe

Fort Lauderdale, FL · Remote

$14 - $17/hr

Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a medical scribe first! Scribe Pay Structure: $11/hour - No scribe experience $12/hour - 6+ months scribe ...

Osaic

Sr. Financial Planning Strategist

Boca Raton, FL · On-site +1

$140K - $160K/yr

Petersburg, FL 33702 Remote applicants may potentially be considered for this role. Osaic has ... Eligibility Applicants for employment in the US must have valid work authorization that does not ...

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All JobsPrior Authorization Rn JobsRemote Prior Authorization Rn JobsRemote Prior Authorization Rn Jobs in Boca Raton, FL

Remote Prior Authorization Rn information

See Boca Raton, FL salary details

$7

$40

$68

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

As of Aug 19, 2026, the average hourly pay for remote prior authorization rn in Boca Raton, FL is $40.09, according to ZipRecruiter salary data. Most workers in this role earn between $29.90 and $47.45 per hour, depending on experience, location, and employer.

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 Boca Raton, FL?

For Remote Prior Authorization Rn jobs in Boca Raton, FL, the most frequently searched job titles are:

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The top searched job categories for Remote Prior Authorization Rn jobs in Boca Raton, FL are:

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Remote Prior Authorization Rn jobs near you
Infographic showing various Remote Prior Authorization Rn job openings in Boca Raton, FL as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $83,383 per year, or $40.1 per hour.

Adjudication Specialist - Remote

LTC PHARMA HLDG LLC

Fort Lauderdale, FL • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 14 days ago

Job description

WHO WE ARE
At Polaris Pharmacy Services, we're more than a pharmacy - we're a dedicated partner in care, transforming how patients experience long-term, post-acute, correctional, PACE, and specialty pharmacy services. As industry leaders, we're raising the bar for quality and coordination across all sites of care, ensuring every patient receives seamless, compassionate, and expert support.
Founded in 2015, Polaris is proud to be locally and independently owned, with a growing national footprint. Our team thrives in a mission-driven environment where innovation meets purpose, and every role contributes to making a real impact. We offer more than just a job - we provide competitive pay, robust benefits, and genuine opportunities for career advancement.
If you're passionate about shaping the future of pharmacy and making a difference in the lives of those who need it most, we invite you to grow with us.
JOB SUMMARY:
The Adjudication Specialist manages a portfolio of rejected pharmacy claims, ensuring timely billing and maximum payer reimbursement. They prioritize customer needs, maintain courteous communication, and build effective relationships with colleagues and clients. Their goal is to uphold customer trust and enhance our services.
DUTIES/RESPONSIBILITIES:
  • Manage and Identify Claims Portfolio:
    • Review and evaluate insurance claims to determine the extent of the insurer's liability, adhering to policy provisions and state and federal regulations.
    • Authenticate claimants and verify the accuracy of claim submission documents to prevent fraud and ensure compliance with policy terms.
  • Resolve Rejected Claims:
  • Calculate benefit payments and approve claim settlements based on policy coverage and assessment findings.
  • Coordinate with healthcare providers, repair services, or other parties to obtain additional documentation necessary for claim resolution.
  • Effective Communication and Risk Management:
  • Negotiate settlements with claimants or their representatives in cases of disputed claims.
  • Monitor and resolve revenue risks associated with payer setup, billing, rebilling, and reversal processes.
  • Policy Interpretation and Compliance:
  • Interpret and apply complex insurance policy language to diverse claim scenarios.
  • Provide detailed explanations to claimants regarding the adjudication process, claim denials, or settlement offers
  • Additional Responsibilities:
  • Implement alternative dispute resolution methods when conventional negotiation does not achieve a settlement.
  • 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.
  • Duties may vary depending on business needs and operational context.

QUALIFICATIONS/COMPETENCIES:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
REQUIRED SKILLS/ABILITIES:
  • Able to read, write, speak, and understand the English language
  • Able to retain a large amount of information and apply that knowledge to related situations
  • Able to work in a fast-paced environment
  • Basic computer knowledge skills required
  • Basic math and analytical skills
  • Experience with alpha-numeric data entry
  • Proficient in Microsoft Word, Excel, and Outlook required
  • Customer Service
  • Results-oriented
  • Good organization/Attention to detail
  • Reliable
  • Problem solver
  • Able to work various shifts and days
  • Adaptability to an ever-changing environment

EDUCATION and/or EXPERIENCE:
  • High School diploma or equivalent required
  • Minimum of one (1) or more years working as a pharmacy technician in a retail environment required (long-term care pharmacy preferred)
  • Framework LTC & General computer knowledge & 10-key Number Entry preferred

PHYSICAL DEMANDS
The physical demands described here are representative of those that should be met by an employee to successfully perform the essential functions of this job:
  • May sit or stand seven (7) to ten (10) hours per day
  • The employee is occasionally required to sit; climb or balance; and stoop, kneel, bend, walk
  • May be necessary to work extended hours as needed
  • May lift and/or move up to 30 pounds
  • The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role

HOLIDAY & PTO POLICY
  • Paid holidays are provided annually, with 6 days offered each year, along with 5 sick days.
  • Employees earn up to 10 PTO days each year, with rollover options and milestone bonuses.
  • Employees have the option to cash out up to 10 PTO hours each quarter for added financial flexibility.

Please note, because we are a pharmacy most of our locations are open 24-hours a day, 7 days a week and therefore schedules may change as determined by the needs of the business.
BENEFITS for full time Employees
  • Medical, Dental, and Vision insurance
  • 401 (k) (available for Part Time & Full Time EEs)
  • Company Paid Life insurance
  • Short-term and Long-term disability insurance
  • Tuition reimbursement
  • Personal Time Off (PTO)
  • Competitive pay with annual performance reviews and merit-based raises
  • Career growth potential
  • Annual on-site voluntary Flu Vaccines
  • Employee referral bonus program

Apply