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Remote Prior Authorization Jobs in Pleasant Prairie, WI

Advocate Aurora Health

HTM Contract Manager

Burlington, WI · Remote

$47.50 - $71.25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

This role is primarily remote with possibility of travel as needed for meetings, training, or ... rate summaries, prior authorization requirements and other contract operational documents.

New

IQVIA

Flex Nurse Educator

North Chicago, IL · Remote

Bilingual in English/Spanish and prior Ambassador experience desirable. * BSN preferred ... authorization to work in the US without the need for sponsorship. #LI-CES #LI-REMOTE IQVIA is a ...

State of Wisconsin

Associate Medical Director

Sturtevant, WI · On-site +1

$99.74 - $141.45/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Job Details Applicants must be legally authorized to work in the United States (i.e. a citizen or ... This position has the flexibility of a hybrid in-office and remote work schedule of up to 3 days ...

State of Wisconsin

Teacher - Special Education

Racine, WI · On-site +1

$30.01 - $35.76/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Job Details Applicants must be legally authorized to work in the United States (i.e. a citizen or ... This position is not eligible for remote work. Qualifications Special Requirements Must be licensed ...

New

Grainger Businesses

Shoemobile Analyst

Lake Forest, IL · On-site +1

$57K - $95K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Remote Req Number 333111 About Grainger W.W. Grainger, Inc. is a leading broad line distributor ... Only individuals authorized to work in the United States now and for the foreseeable future will be ...

Grainger Businesses

Shoemobile Analyst

Lake Forest, IL · On-site +1

$57K - $95K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Remote Req Number 333111 About Grainger W.W. Grainger, Inc. is a leading broad line distributor ... Only individuals authorized to work in the United States now and for the foreseeable future will be ...

micro1 AI

Clinical Pharmacy Technicians

Kenosha, WI · Remote

$70 - $80/hr

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... No prior experience in AI is required -- your domain knowledge is what matters. This opportunity is ...

DGI Supply

Customer Service Representative

Vernon Hills, IL · On-site +1

$23/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Ability to multi-task REMOTE/HYBRID WORK REQUIREMENTS : In order to work remotely the Employee Must: * Reside in the United States or Canada. * Have access to high-speed reliable internet (with a ...

Addison Group

Customer Service Representative

Buffalo Grove, IL · Remote

$22 - $25/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Able to work onsite everyday and two days remote after training * Strong organizational skills with attention to detail. * Excellent verbal and written communication skills. Additional Details:

Novolex

Customer Service Representative

Lake Forest, IL · On-site +1

$22.60/hr

  • Medical

  • Dental

  • Vision

Park City, FL; or Raleigh, NC - This role is a hybrid role, not strictly remote. Key Responsibilities: * Manage customer orders, ensuring accurate and timely processing in line with company policies.

Staples, Inc.

Customer Service Representative

Old Mill Creek, IL · On-site +1

$15.25 - $20.75/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

This position is a minimum of 4 days in the office at our Lincolnshire, IL location with flexibility for remote work on Fridays. Staples is business to business. You're what binds us together. At ...

Staples, Inc.

Customer Service Representative

Waukegan, IL · On-site +1

$15.25 - $20.75/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

This position is a minimum of 4 days in the office at our Lincolnshire, IL location with flexibility for remote work on Fridays. Staples is business to business. You're what binds us together. At ...

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All JobsPrior Authorization JobsRemote Prior Authorization JobsRemote Prior Authorization Jobs in Pleasant Prairie, WI

Remote Prior Authorization information

See Pleasant Prairie, WI salary details

$13

$20

$31

How much do remote prior authorization jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for remote prior authorization in Pleasant Prairie, WI is $20.25, according to ZipRecruiter salary data. Most workers in this role earn between $16.78 and $22.36 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

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For Remote Prior Authorization jobs in Pleasant Prairie, WI, the most frequently searched job titles are:

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What cities near Pleasant Prairie, WI are hiring for Remote Prior Authorization jobs?

Cities near Pleasant Prairie, WI with the most Remote Prior Authorization job openings:

Remote Prior Authorization jobs near you
Infographic showing various Remote Prior Authorization job openings in Pleasant Prairie, WI as of August 2026, with employment types broken down into 1% As Needed, 71% Full Time, 25% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $42,119 per year, or $20.2 per hour.

Prior Authorization/Referral Specialist

Froedtert South, Inc.

Pleasant Prairie, WI • On-site, Remote

$17 - $25.25/hr

Part-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 4 days ago

Froedtert South rating

6.9

Company rating: 6.9 out of 10

Based on 39 frontline employees who took The Breakroom Quiz

459th of 887 rated healthcare providers

Job description

  • POSITION PURPOSE
    • The Prior-Authorization/Referral Specialist plays a key role in supporting patient access to care by verifying insurance eligibility and benefits, and securing required pre-certifications, authorizations, and referrals for both facility and professional services. This position ensures timely and accurate communication with payors and healthcare providers, obtains necessary clinical documentation to support medical necessity, and maintains detailed records throughout the authorization process.
  • MINIMUM EDUCATION REQUIRED
    • High School or GED
  • MINIMUM EXPERIENCE REQUIRED
    • One (1) year of insurance/prior authorization experience (preferred)
    • Experience and familiarity with using insurance portals
  • LICENSES / CERTIFICATIONS REQUIRED
    • None
  • KNOWLEDGE, SKILLS & ABILITIES REQUIRED
    • Strong customer service orientation with excellent interpersonal and computer skills.
    • Working knowledge of medical terminology and healthcare documentation standards.
    • Demonstrated ability to manage time effectively, prioritize tasks, and maintain accuracy in a high-volume environment.
    • Proficient with internet-based tools, email communication, and Microsoft Office applications (e.g., Word, Excel, Outlook).
    • Strong written and verbal communication skills, with the ability to interact professionally with patients, clinicians, and insurance representatives.
    • Proven experience in prior authorizations, referrals, patient registration, insurance verification, and understanding of various health insurance plans (preferred).
    • Proficient in navigating online prior authorization portals and working with multiple commercial and government payors (preferred).
    • Knowledge of medical coding systems, including ICD-10, CPT, and HCPCS codes (preferred).
  • PRINCIPLE ACCOUNTABILITIES AND ESSENTIAL DUTIES
    • Verify insurance eligibility and benefits for scheduled services to determine prior-authorization or referral requirements.
    • Initiate and follow through on prior-authorization and referral requests with payors, ensuring timely approvals.
    • Collect and submit required clinical documentation to support medical necessity and facilitate authorization.
    • Document all authorization activities accurately in the electronic health record (EHR) and/or designated tracking systems.
    • Communicate authorization status and requirements clearly to providers, clinical staff, and patients as needed.
    • Coordinate with providers and clinical teams to obtain additional information or clarification required by payors.
    • Maintain up-to-date knowledge of payer policies, coding guidelines (ICD-10, CPT, HCPCS), and authorization processes.
    • Ensure timely resolution of authorization-related issues to prevent delays or denials in patient care or billing.
    • Provide exceptional customer service when interacting with internal teams, external payors, and patients.
    • Participate in continuous quality improvement efforts, including audits, training, and performance reviews.
       
      Salary Range: $17.00 to $25.25/hr (based on experience)
       

      Benefits:

      • Medical, dental and vision benefits available
      • 403(b) company match available
      • Tuition reimbursement
      • Employee discount program
      • Competitive PTO

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