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Remote Prior Authorization Jobs in Mount Pleasant, SC

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Remote Prior Authorization information

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$13

$19

$30

How much do remote prior authorization jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for remote prior authorization in Mount Pleasant, SC is $19.97, according to ZipRecruiter salary data. Most workers in this role earn between $16.54 and $22.07 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 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.
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Remote Prior Authorization jobs near you
Infographic showing various Remote Prior Authorization job openings in Mount Pleasant, SC as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 20% Part Time, 1% Temporary, and 2% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $41,539 per year, or $20 per hour.

Healthcare Administrative Specialist

KC Elite Staffing LLC

North Charleston, SC • Remote

$45 - $50/hr

Contractor

Posted 7 days ago

Job description

About the Opportunity

KC Elite Staffing is seeking experienced healthcare administrative and operations professionals for a remote contract opportunity. This is authoring and judgment-based work — not volume processing. You will draw on your real-world expertise to design realistic scenarios, build supporting documentation, and evaluate healthcare operations tasks. If you are a seasoned healthcare back-office professional who owns complex problems, this role was built for you.

Priority Areas — Hiring Immediately

We are actively seeking candidates with hands-on experience in one or more of the following:

  • Medical Coding — inpatient, outpatient, pro-fee, risk adjustment/HCC coding, coding audits
  • Prior Authorization & Utilization Management — submitting and tracking authorizations through payer portals, utilization review
  • Revenue Cycle Operations — denials and appeals, A/R follow-up, payment integrity, underpayment recovery, coordination of benefits, secondary billing

Also In Scope

  • Claims and full-cycle medical billing
  • Regulatory compliance and HIPAA privacy
  • Healthcare internal audit
  • Payer-side operations — claims adjudication, appeals and grievances, benefit configuration, provider network, utilization management
  • Clinical Documentation Integrity (CDI), DRG validation, Health Information Management
  • Revenue integrity, charge master (CDM), managed care and reimbursement analysis
  • Practice, clinic, and hospital administration
  • Director/VP of Revenue Cycle level experience welcome

Requirements

  • 3+ years of hands-on, recent experience in a healthcare administrative or back-office role
  • Currently working in a qualifying role
  • Direct experience with payer portals such as Availity, Optum/Change Healthcare, Waystar, Office Ally, or individual payer hubs
  • Familiarity with EHR/practice management platforms, encoders, computer-assisted coding tools, and/or clearinghouses
  • Ability to commit 15+ hours per week
  • Must be located in the United States
  • Must be authorized to work as an independent contractor — H1-B and STEM OPT candidates cannot be considered at this time

What Makes a Strong Candidate

We are looking for professionals who can construct and solve complex problems — not process volume. Strong candidates will have experience such as:

  • Owning an appeal or payer dispute end to end
  • Running coding or DRG audits
  • Defending a code assignment through appeal
  • Leading an EHR conversion or payer implementation
  • Writing SOPs or payer-specific workflow documentation
  • Supervising staff or sitting on a denials or audit committee
  • Experience across two or more care settings or on both the provider and payer side

Settings We Consider

Physician groups, ambulatory practices, ambulatory surgery centers, skilled nursing and long-term care, home health and hospice, behavioral health, dialysis, infusion and specialty pharmacy, retail pharmacy and PBM prior authorization, DME suppliers, FQHCs, health plans and TPAs, RCM outsourcers and clearinghouses.

Not a Fit For

Clinical care roles, front desk, patient registration, appointment scheduling, call center script-following, medical scribes, or transcription-only roles.

How to Apply

Submit your application through KC Elite Staffing. Qualified candidates will receive next steps via email within 1–2 business days.