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Remote Prior Authorization Rn Jobs in Philadelphia, PA

HealthSkil

Be Seen First

Fully Remote Registered Nurse (RN) Care Manager

Philadelphia, PA · Remote

$90K - $98K/yr

As an RN Care Manager, you will play a vital role in delivering holistic, patient-centered care ... Preferred candidates will have prior experience in case management, care coordination, or managed ...

MVP Recovery

PRN Remote CRNP

Chester, PA · On-site +1

$90K - $121K/yr

Flexible | PRN Position Overview MVP Recovery is seeking a Certified Registered Nurse Practitioner (CRNP) to provide follow-up medication management appointments in a PRN, primarily remote capacity.

Novacore

Medical Review Nurse

Conshohocken, PA · Remote

The Medical Review Nurse is a registered nurse who can assist Novacore's Claim and Underwriting ... Prior experience analyzing health care claims and coding. * Prior experience working with ...

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Remote Prior Authorization Rn information

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$7

$42

$72

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

As of Jul 24, 2026, the average hourly pay for remote prior authorization rn in Philadelphia, PA is $42.63, according to ZipRecruiter salary data. Most workers in this role earn between $31.78 and $50.43 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 Philadelphia, PA? For Remote Prior Authorization Rn jobs in Philadelphia, PA, the most frequently searched job titles are:
What job categories do people searching Remote Prior Authorization Rn jobs in Philadelphia, PA look for? The top searched job categories for Remote Prior Authorization Rn jobs in Philadelphia, PA are:
What cities near Philadelphia, PA are hiring for Remote Prior Authorization Rn jobs? Cities near Philadelphia, PA 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 Philadelphia, PA as of July 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $88,666 per year, or $42.6 per hour.
REMOTE Prior Authorization Pharmacist

REMOTE Prior Authorization Pharmacist

Insight Global

Philadelphia, PA • Remote

$58.50 - $59/hr

Contractor

Medical, Dental, Vision

Posted yesterday

Job description

The Pharmacist, Prior Authorization (PA) & Appeals, is responsible for reviewing and evaluating prior authorization and appeals requests to determine coverage based on clinical guidelines, pharmacy policies, and health plan benefits. In this fast-paced, high-volume environment, the pharmacist works closely with physicians, healthcare providers, pharmacy technicians, and internal teams to gather and assess clinical information, make evidence-based coverage determinations, recommend formulary-compliant and cost-effective treatment alternatives, and ensure compliance with federal and state regulations. The role requires strong clinical judgment, attention to detail, effective communication skills, and the ability to manage competing priorities while meeting productivity and quality standards. Additionally, the pharmacist supports quality assurance initiatives, resolves provider and pharmacy inquiries, participates in process improvement efforts, and contributes to a collaborative, customer-focused team environment. Maintain full compliance with state and federal pharmacy laws, Medicare Part D, Medicaid, and commercial benefit regulations. Accurately document case decisions in accordance with internal protocols, auditing standards, and confidentiality policies. Effectively manage case volume by organizing workload, setting daily priorities, and meeting productivity and quality benchmarks. Adapt to fluctuating demands while maintaining accuracy and professionalism under pressure.

  • Requirements:
    • Bachelor's or Doctorate of Pharmacy
    • Active State Pharmacist License / Current Licensed Pharmacist in state of work
    • 6+ months of customer service/customer relations experience with healthcare professionals
    • Basic proficiency with Microsoft Excel, Word, and Outlook
    • Comfortable working in a call center/production-based environment
    • Ability to work remotely with little to no supervision
    • Strong adaptability in a fast-paced, high-volume setting
  • Duration: 6-Month Contract
  • Location: Remote
  • Day-to-Day:
    • Review and evaluate prior authorization and appeal requests for pharmacy coverage determinations
    • Assess clinical information and apply pharmacy policies, clinical guidelines, and health plan benefits
    • Collaborate with physicians, healthcare providers, pharmacy technicians, and internal teams
    • Recommend formulary-compliant and cost-effective treatment alternatives
    • Ensure compliance with state and federal pharmacy regulations, Medicare Part D, Medicaid, and commercial benefit requirements
    • Manage a high-volume caseload while maintaining quality and productivity standards
    • Document case decisions and assist with quality assurance and process improvement initiatives