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Remote Prior Authorization Jobs in Florida (NOW HIRING)

Humata Health

  • Medical

  • Life

  • Retirement

  • PTO

Remote - USA • What you'll do: End-to-End Technical Integration Delivery * Lead end-to-end design ... Revenue cycle systems, prior authorization systems * Proficient in configuring and troubleshooting ...

Amgen

Field Reimbursement Manager- Orlando, FL

Orlando, FL · On-site +1

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

... payer prior authorization to appeals/denials requirements and forms * Review patient-specific ... General office demands - Remote, Work from Home. * One to two home office days per week. * Must be ...

AO Globe Life

Remote Sales Associate - Entry Level

Jacksonville, FL · On-site +1

$34K - $46K/yr

  • Medical

  • Life

  • Retirement

No Prior Experience - Full Training Provided Start Date: Hiring Immediately Most Responsive Hiring ... Must be at least 18 years old and legally authorized to work in the U.S. * Strong verbal and ...

Adventuresbyamerica

Remote Vacation Planner

Orlando, FL · Remote

... and authorized to work in your location Prior travel industry experience is helpful but not required; training is provided What We Offer Remote work environment Structured onboarding and ongoing ...

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All JobsPrior Authorization JobsRemote Prior Authorization JobsRemote Prior Authorization Jobs in Florida

Remote Prior Authorization information

What is a remote prior authorization job?

Remote prior authorization jobs involve reviewing and processing requests from healthcare providers to determine if specific medical treatments, medications, or procedures are covered by a patient's insurance plan. Employees in these roles work from home, utilizing online systems to evaluate clinical information, communicate with providers, and ensure compliance with insurance policies. This position requires a strong understanding of medical terminology, insurance guidelines, and attention to detail to facilitate timely and accurate approvals or denials. Remote prior authorization specialists help streamline patient care by acting as a liaison between healthcare providers and insurance companies.

What is a remote prior authorization job?

Remote prior authorization jobs focus on working with insurance companies to coordinate benefit coverage and get approval to provide care for a patient. In this pre-authorization role, you may collect documentation and proof of insurance, perform data entry, help evaluate the need for a particular process, and otherwise work from home to help manage the prior authorization process. Remote prior authorization personnel often answer telephone calls to provide consultations, perform initial benefit verification, document case status, actions, and outcomes in a database, and use customer service skills to help expedite cases as needed. Since this is a remote call center-style job, you may be asked to arrange for a quiet office in your house that is free of distractions.

What are the key skills and qualifications needed to thrive as a remote prior authorization specialist, and why are they important?

To thrive as a Remote Prior Authorization Specialist, you need a solid understanding of medical terminology, insurance processes, and healthcare regulations, often supported by experience in medical billing or coding. Familiarity with electronic health record (EHR) systems, insurance portals, and prior authorization software is typically required. Attention to detail, strong organizational skills, and effective communication are crucial soft skills in this role. These skills ensure timely and accurate processing of authorizations, reducing claim denials and supporting efficient patient care.

What are some common challenges faced by remote prior authorization specialists, and how can they be addressed?

Remote Prior Authorization specialists often encounter challenges such as navigating complex insurance requirements, managing high volumes of requests, and maintaining clear communication with healthcare providers and payers. Staying organized and up-to-date on payer policies is crucial, as requirements can vary widely between insurers. Utilizing workflow management tools and fostering strong collaboration with clinical and administrative teams can help streamline processes and reduce delays, ultimately ensuring patients receive timely care.

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

AspectRemote Prior AuthorizationRemote Medical Coder
Required CredentialsMedical credentials, insurance knowledgeMedical coding certification (CPC, CCS)
Work EnvironmentHealthcare offices, insurance companies, remoteHealthcare facilities, remote coding jobs
Industry UsageInsurance, healthcare providersHospitals, clinics, billing companies
Job FocusReviewing and approving insurance requestsTranslating medical records into codes

Remote Prior Authorization and Remote Medical Coder roles both operate within the healthcare industry but focus on different tasks. Remote Prior Authorization involves reviewing insurance requests for coverage approval, requiring insurance and medical knowledge. Remote Medical Coders translate medical records into standardized codes, primarily focusing on billing and documentation. Both roles can be performed remotely and require healthcare-related credentials, but their daily responsibilities and skill sets differ significantly.

Are remote prior authorization jobs in high demand?

Remote prior authorization jobs are in moderate to high demand due to the increasing need for efficient healthcare administration and insurance processing. These roles often require knowledge of healthcare policies, strong communication skills, and familiarity with electronic health record systems. The demand is expected to grow as healthcare providers and insurers continue to prioritize remote and streamlined authorization processes.
More about Remote Prior Authorization jobs

What are the most commonly searched types of Prior Authorization jobs in Florida?

The most popular types of Prior Authorization jobs in Florida are:

What are popular job titles related to Remote Prior Authorization jobs in Florida?

For Remote Prior Authorization jobs in Florida, the most frequently searched job titles are:

What job categories do people searching Remote Prior Authorization jobs in Florida look for?

The top searched job categories for Remote Prior Authorization jobs in Florida are:

What cities in Florida are hiring for Remote Prior Authorization jobs?

Cities in Florida with the most Remote Prior Authorization job openings:

Remote Prior Authorization jobs near you
Infographic showing various Remote Prior Authorization job openings in Florida as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 17% Part Time, 1% Temporary, and 2% Contract. Highlights an 93% Physical, 1% Hybrid, and 6% Remote job distribution.

Denial Recovery Coding Analyst | Enterprise Denials - Durbin Park

UF Health

Saint Johns, FL • Remote

Full-time

Posted 3 days ago

New

Job description

Overview

Work remotely while using your denial management expertise to make a direct impact on healthcare operations.

???? Work Style: Remote
???? Location Requirement: Must reside in an approved state (FL, GA, PA, NC, SC, TN, or TX)
???? FTE: Full-Time (1.0 FTE)

Responsible for maintaining low denial rates and optimizing reimbursement across the enterprise by ensuring high coding standards and effective denial management practices. Leads and supports initiatives to improve coding accuracy, reimbursement outcomes, and appeal turnaround times.

Performs in-depth analysis of denial trends, including Epic system edits, coding validation, Charge Description Master (CDM) processes, authorization trends, and payer denials. Identifies opportunities for performance improvement and implements strategies to enhance revenue cycle outcomes.

Educates departments on appropriate charging, billing, and coding practices to ensure regulatory compliance. Collaborates with Managed Care, Compliance, and operational teams to resolve complex issues with departments and payers, driving sustainable improvements in reimbursement and denial prevention.


Responsibilities

Key Responsibilities

  • Manages clinical denials from assigned denial workqueues, including claim resubmissions, authorization verification, payer claim reprocessing, reconsiderations, and appeals.
  • Partners with managed care teams and payers to reduce denials and maximize reimbursement.
  • Identifies opportunities to improve coding and clinical documentation based on denial trends and coding guidelines.
  • Meets established productivity and quality standards while managing assigned denial workqueues.
  • Reviews and corrects accounts using coding software, NCCI, ICD-10, CPT, HCPCS, and CMS coding guidelines.
  • Collaborates with department leadership to investigate, track, trend, and resolve coding, charging, billing, and compliance issues.
  • Manages multiple payer workqueues, including Medicare, Medicaid, Medicare Advantage, commercial, and government payers.
  • Researches denials related to authorization, medical necessity, coding, billing, non-covered services, and documentation, initiating timely appeals to prevent filing deadline issues.
  • Prepares detailed reconsiderations and appeal submissions based on medical record review and organizational policies.
  • Identifies payer-specific denial trends, performs root cause analysis, and escalates findings to management for corrective action.
  • Reviews payer communications to identify reimbursement risks related to medical policies and prior authorization requirements.
  • Reviews and corrects coding, modifiers, diagnosis sequencing, and charges in accordance with coding, charging, documentation, and billing guidelines.
  • Partners with operational departments to educate staff, improve documentation and authorization practices, reduce denials, and strengthen overall revenue cycle performance.
 
 
 

Qualifications

Education

• High School Diploma or GED required.
• One of the following coding certifications required: CPC, COC, RHIT, RHIA, or CCS.

Minimum Qualifications

  • 1–2 years of medical coding experience.
  • 1–2 years of denial management and/or health insurance experience.
 
 

Preferred 

• One (2) to three (3) years of coding experience required.
• One (1) to three (3) years of denial management and/or insurance-related experience required.

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