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Remote Prior Authorization Jobs in Edgewater, NJ

Shields Health Solutions

Clinical Pharmacist

New York, NY · On-site +1

$129K - $154K/yr

... for prior authorization approvals and development of care plan recommendations. * Develop and ... Maintaining current registration and all remote pharmacist activity to comply with local, state and ...

US Fertility

Financial Educator Remote

Manhattan, NY · On-site +1

$23 - $28/hr

Opportunity Overview We have an immediate opening for an Financial Educator Remote to join our team ... Perform aspects of benefit verification and prior authorization * Provide ongoing financial ...

Medix

Registered Nurse

New York, NY · Remote

$48 - $55/hr

Support utilization review, prior authorization reviews, appeals, and clinical documentation ... Fully Remote * Company-issued laptop provided * Indefinite contract opportunity Equipment Policy ...

Intend Inc d.b.a. Tangelo

Be Seen First

Remote Enrollment Services Contractor

New York, NY · Remote

$25 - $28/hr

Prior experience with JIRA, Intercom, and CloudTalk is a plus. * Operational Independence : Strong ... This is a remote position, but the contractor must reside in New York and be legally authorized to ...

Glow Forward ABA

ABA Revenue Cycle Manager

Monsey, NY · On-site +1

... remote arrangement. As we continue to grow, we are bringing our revenue cycle operations in-house ... Prior authorizations * Claims submission * Payment posting * Accounts receivable * Denial ...

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All JobsPrior Authorization JobsRemote Prior Authorization JobsRemote Prior Authorization Jobs in Edgewater, NJ

Remote Prior Authorization information

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How much do remote prior authorization jobs pay per hour?

As of Aug 13, 2026, the average hourly pay for remote prior authorization in Edgewater, NJ is $21.94, according to ZipRecruiter salary data. Most workers in this role earn between $18.17 and $24.23 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 job categories do people searching Remote Prior Authorization jobs in Edgewater, NJ look for? The top searched job categories for Remote Prior Authorization jobs in Edgewater, NJ are:
What cities near Edgewater, NJ are hiring for Remote Prior Authorization jobs? Cities near Edgewater, NJ with the most Remote Prior Authorization job openings:
Remote Prior Authorization jobs near you
Infographic showing various Remote Prior Authorization job openings in Edgewater, NJ as of August 2026, with employment types broken down into 81% Full Time, and 19% Part Time. Highlights an 100% Remote job distribution, with an average salary of $45,642 per year, or $21.9 per hour.

Care Coordination Representative

Advanced Medical Management

Englewood Cliffs, NJ • Remote

$22 - $24/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 4 days ago

Job description

Job Description

We are seeking a Bilingual Call Center Representative fluent in spoken Korean and English to join our team in Englewood Cliffs, NJ. This role includes handling both inbound and outbound calls and serving as a key point of contact between our organization, patients, physician offices, and hospitals.

The ideal candidate is friendly, professional, organized, and able to solve problems quickly and effectively. This position will support matters related to claims, prior authorizations, referrals, care coordination, and general patient support.

This role is currently on-site, with the possibility of transitioning to a remote or hybrid arrangement in the future based on business needs and performance. Training will be provided, though prior healthcare experience is strongly preferred and a major plus.

Responsibilities

  • Answer inbound calls from patients, physician offices, and hospitals
  • Make outbound calls to patients for follow-up, care coordination, and support
  • Communicate with patients, physician offices, and hospitals to help resolve issues
  • Assist with claims, prior authorizations, referrals, scheduling, and related matters
  • Document calls and follow-up actions accurately
  • Escalate more complex issues when needed
  • Provide friendly, professional customer service
  • Support other call center and administrative tasks as needed

Qualifications

  • Fluent in spoken Korean and English
  • Strong communication and customer service skills
  • Friendly, professional, and patient demeanor
  • Strong problem-solving and troubleshooting skills
  • Organized and able to manage multiple tasks
  • Comfortable speaking with patients and physician offices by phone
  • Training will be provided
  • Prior call center or customer service experience preferred
  • Prior healthcare experience is highly desired and a significant advantage
  • Experience with claims, referrals, prior authorizations, or care coordination is a plus

AMM BENEFITS

When you join AMM, you’re not just getting a job—you’re getting a benefits package that puts YOU first:

  • Health Coverage You Can Count On: Full employer-paid HMO and the option for a flexible PPO plan.
  • Wellness Made Affordable: Discounted vision and dental premiums to help keep you healthy from head to toe.
  • Smart Spending: FSAs to manage healthcare and dependent care costs, plus a 401(k) to secure your future.
  • Work-Life Balance: Generous PTO, 40 hours of sick pay, and 13 paid holidays to enjoy life outside of work.
  • Career Development: Tuition reimbursement to support your education and growth.