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Remote Prior Authorization Jobs in Kentucky (NOW HIRING)

PharMerica

Prior Authorization Specialist

Louisville, KY · On-site +1

$16.50 - $22/hr

Mon-Fri(8:30am to 5pm) This is not a remote opportunity . Applicants must reside in, or commutable ... The Prior Authorization Coordinator is responsible for striving to complete either approval for ...

PharMerica

Prior Authorization Specialist

Louisville, KY · On-site +1

$16.50 - $22/hr

Mon-Fri(8:30am to 5pm) This is not a remote opportunity . Applicants must reside in, or commutable ... The Prior Authorization Coordinator is responsible for striving to complete either approval for ...

Onco360

$19.75 - $25.50/hr

Remote work possible after initial on-site training. Why Join Us? * A career with purpose: Help ... Manage prior authorization requests and appeals with insurance carriers. * Collaborate with ...

New

Onco360

Pharmacy Prior Authorization Specialist

Louisville, KY · On-site +1

$18.75 - $24.25/hr

Remote work possible after initial on-site training. Why Join Us? * A career with purpose: Help ... Manage prior authorization requests and appeals with insurance carriers. * Collaborate with ...

Onco360

$19.75 - $25.50/hr

Remote work possible after initial on-site training. Why Join Us? * A career with purpose: Help ... Manage prior authorization requests and appeals with insurance carriers. * Collaborate with ...

New

BrightSpring

Medicare D Billing Representative

Louisville, KY · Remote

$15.75 - $20.25/hr

Additionally, the Medicare D Biller updates and documents prior authorizations, including clinical ... Remote: May reside anywhere with the Continental USA. No matter what time zone in which you reside ...

PharMerica

Medicare D Billing Representative

Louisville, KY · On-site +1

$15.75 - $20.25/hr

Additionally, the Medicare D Biller updates and documents prior authorizations, including clinical ... Remote: May reside anywhere with the Continental USA. No matter what time zone in which you reside ...

PharMerica

Medicare D Billing Representative

Louisville, KY · On-site +1

$15.75 - $20.25/hr

Additionally, the Medicare D Biller updates and documents prior authorizations, including clinical ... Remote: May reside anywhere with the Continental USA. No matter what time zone in which you reside ...

Harrow, Inc.

Support practices through the prior authorization and appeals process by educating staff on payer ... Remote Travel * Up to 80%

ConnectMed360

Oncology Case Manager

Louisville, KY · On-site +1

$60K/yr

This position is Full-Time , Remote , working Monday - Friday starting out 9:30am to 6:00pm then ... Support the facilitation of prior authorization and appeal processes by gathering necessary ...

MCKESSON

Field Reimbursement Manager

Lexington, KY · On-site +1

... Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client ...

MCKESSON

Field Reimbursement Manager

Florence, KY · On-site +1

... Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client ...

MCKESSON

Field Reimbursement Manager

Richmond, KY · On-site +1

... Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client ...

MCKESSON

Field Reimbursement Manager

Somerset, KY · On-site +1

... Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client ...

MCKESSON

Field Reimbursement Manager

Louisville, KY · On-site +1

... Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client ...

Legion Health

$50K - $150K/yr

... verification, billing, prior authorizations, pharmacy coordination, etc. * Commitment to ... Fully remote within the United States. * Schedule: Part-time * Compensation: $50K-150K per year ...

Valeris

Executive Case Manager (Remote)

Pikeville, KY · Remote

This includes completing benefit investigations, tracking prior authorizations / denial appeals ... Remote work eligibility is subject to all work from home criteria met and based on business need ...

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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 Kentucky?

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

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

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

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

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

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

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

Remote Prior Authorization jobs near you
Infographic showing various Remote Prior Authorization job openings in Kentucky as of August 2026, with employment types broken down into 89% Full Time, and 11% Part Time. Highlights an 100% Remote job distribution.

Prior Authorization Specialist

PharMerica

Louisville, KY • On-site, Remote

$16.50 - $22/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 20 days ago

PharMerica rating

6.6

Company rating: 6.6 out of 10

Based on 103 frontline employees who took The Breakroom Quiz

65th of 113 rated pharmacies

Job description

Our Company
PharMerica
Overview
Join our PharMerica team! PharMerica is a closed-door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacy environment. Our organization is in high growth mode, which means advancement opportunities for individuals who are looking for career progression!
Schedule: Mon-Fri(8:30am to 5pm)
This is not a remote opportunity. Applicants must reside in, or commutable distance, to Louisville, KY
We offer:
DailyPay
Flexible schedules
Competitive pay
Shift differential
Health, dental, vision and life insurance benefits
Company paid STD and LTD
Tuition Assistance
Employee Discount Program
401k
Paid-time off
Tuition reimbursement
Non-retail/Closed-door environment
Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your passion is service excellence and top-quality care come join our team and apply today!
*Position will be posted for a minimum of 7 business days
Responsibilities
  • The Prior Authorization Coordinator is responsible for striving to complete either approval for pharmacy claims requiring prior authorization or by coordinating with prescribers and or facility contact to have therapy changed to a preferred alternative due to insurance not covering the treatment in question

Essential Job Responsibilities:
  • Ensure accurate and timely completion of client prior authorization and/or change of therapy paperwork by collaborating with prescribers and facility contacts
  • Follows up on all claims requiring prior authorization within four to five business days
  • Tracks and reviews all claims in QuickBase and sends excel tracking spreadsheet to Director of Pharmacy on weekly basis
  • Compares system report of unbilled claims requiring prior approval to QuickBase tracking system to ensure any claim requiring prior authorization is being followed up on
  • Assists Billing Department with resolving unbilled claims at each month end close
  • Advocates for clients as needed
  • Support for Pharmacy Operations
  • Adjudicates and resolution of claim rejections as needed
  • Utilizes Frameworks, QuickBase, Docutrack, and CoverMyMeds in order to complete workflow on daily basis
  • Other responsibilities as assigned

Qualifications
  • High School Diploma/General Education Diploma required
  • Kentucky Pharmacy Technician License preferred
  • Excellent customer service and communication skills, both written and verbal
  • Ability to prioritize and meet pre-determined deadlines
  • Must be able to effectively multi-task, be proficient at typing, and have advanced technical skills
  • Experience in healthcare billing environment (pharmacy preferred)
  • Familiarization with on-line claims processing and Medicaid and Medicare billing practices
  • Proficient with Microsoft Word & Excel required

About our Line of Business
PharMerica, an affiliate of BrightSpring Health Services, delivers personalized pharmacy care through dedicated local teams, serving health care providers such as skilled nursing facilities, senior living communities, and hospitals. We also cater to individuals with behavioral needs, infusion therapy needs, seniors receiving in-home care, and patients with cancer. Operating long-term care, home infusion, and specialty pharmacies across the nation, we combine the personal touch of a neighborhood pharmacy with the resources of a national network. Our comprehensive solutions, backed by industry-leading technology and regulatory expertise, ensure accurate medication access, cost control, and compliance with best-in-class clinical standards. We are committed to enhancing resident health, reducing staff burdens, and supporting our clients' success. For more information, visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.

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