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Remote Prior Authorization information

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$12

$18

$29

How much do remote prior authorization jobs pay per hour?

As of Aug 6, 2026, the average hourly pay for remote prior authorization in Butler, PA is $18.84, according to ZipRecruiter salary data. Most workers in this role earn between $15.62 and $20.82 per hour, depending on experience, location, and employer.

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 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 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 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.

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.

More about Remote Prior Authorization jobs
What are the most commonly searched types of Prior Authorization jobs in Butler, PA? The most popular types of Prior Authorization jobs in Butler, PA are:
What are popular job titles related to Remote Prior Authorization jobs in Butler, PA? For Remote Prior Authorization jobs in Butler, PA, the most frequently searched job titles are:
What job categories do people searching Remote Prior Authorization jobs in Butler, PA look for? The top searched job categories for Remote Prior Authorization jobs in Butler, PA are:
What cities near Butler, PA are hiring for Remote Prior Authorization jobs? Cities near Butler, PA with the most Remote Prior Authorization job openings:
Remote Prior Authorization jobs near you
Infographic showing various Remote Prior Authorization job openings in Butler, PA as of August 2026, with employment types broken down into 79% Full Time, and 21% Part Time. Highlights an 100% Remote job distribution, with an average salary of $39,179 per year, or $18.8 per hour.

Clinical Pharmacy Technician II

Highmark Health

Zelienople, PA • Remote

Full-time

Re-posted 20 days ago

Highmark Health rating

7.8

Company rating: 7.8 out of 10

Based on 28 frontline employees who took The Breakroom Quiz

Job description

Company :Allegheny Health NetworkJob Description :

JOB SUMMARY

This role requires a strong understanding of pharmacy benefits, insurance processes, and patient access procedures. Responsibilities include the coordination and administration of effective and efficient processing for pharmacy benefits prior authorization processes, insurance evaluations, addressing patient medication access issues, performing medication reconciliation, and overseeing referral screening/management.

ESSENTIAL RESPONSIBILITIES

  • Prior Authorization & Utilization Management: Reviews pharmacy utilization management (UM) coverage requests for both pharmacy and medical benefits and prepares such cases for clinical review when required. Within the context of the request, applies plan-specific benefits to each case appropriately, summarizes pertinent facts, and cites applicable internal policies and guidelines. (40%)

  • Patient & Provider Coordination: Resolves non-clinical issues independently and acts as a liaison between customers, provider-facing teams, and the Pharmacy Department. Engages in member and provider outreach to resolve issues such as appeal initiation requests, processing errors, and fulfilling notification requirements. Schedules appointments, verifies patient information, and addresses inquiries. Performs referral screening and processing, coordinating with specialists and ensuring timely patient access to necessary services. (30%)

  • Data Management & Compliance: Responsible for all preauthorization entries into applicable databases (i.e., internal medical claims systems, PBM pharmacy systems) to ensure swift and appropriate payment of services deemed medically necessary. Conducts insurance evaluations to determine patient eligibility and coverage for services. Performs medication reconciliation tasks to ensure accurate medication lists and prevent potential drug interactions. Maintains regulatory compliance and resolves all cases within predetermined timeframes. Assists patients with applications to access affordable medications. (30%)

  • Other duties as assigned or requested.

QUALIFICATIONS
Required

  • 2 years of experience as a Pharmacy Technician, Patient Access Coordinator, or Medical Assistant in health care setting


Preferred

  • Associate degree

  • Certified Pharmacy Technician (CPhT) from Pharmacy Technician Certification Board


Language (Other than English):

None

Travel Requirement:

0% - 25%

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

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About Highmark Health

Sourced by ZipRecruiter

A national blended health organization, Highmark Health and our leading businesses support millions of customers with products, services and solutions closely aligned to our mission of creating remarkable health experiences, freeing people to be their best. Headquartered in Pittsburgh, we're regionally focused in Pennsylvania, Delaware, West Virginia, and eastern and northwestern New York with customers in 50 states and the District of Columbia. We passionately serve individual consumers and fellow businesses alike. And our companies cover a diversified spectrum of essential health-related needs including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative, technology solutions. Our financial position reflects strength and stability, with our year-end 2022 consolidated revenues totaling $26 billion. And we're proud to carry forth an important legacy of compassionate care and philanthropy that began more than 170 years ago. This tradition of giving back, reinvesting and ensuring that our communities remain strong and healthy is deeply embedded in our culture, informing our decisions every day.

Industry

Health care and social assistance and insurance services

Company size

10,000+ Employees

Headquarters location

Pittsburgh, PA, US

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