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Remote Prior Authorization Jobs in Racine, WI (NOW HIRING)

DRUM Associates

Be Seen First

Customer Service Representative

Milwaukee, WI · Remote

$24/hr

Knowledge of Medicare, Medicaid, insurance verification, prior authorizations, or healthcare documentation workflows Work Environment * Remote - but must be location in Wisconsin or Minnesota

Expressable

Speech-Language Pathologist

Milwaukee, WI · Remote

$40 - $54/hr

100% remote | W2 employment | $40 - $54/hour | Flexible Scheduling (It is required to hold a state ... Specialized team for patient insurance, billing, authorizations, and more so you can focus on care

State of Wisconsin

Associate Medical Director

Sturtevant, WI · On-site +1

$99.74 - $141.45/hr

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 ...

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Remote Prior Authorization information

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$12

$19

$30

How much do remote prior authorization jobs pay per hour?

As of Aug 5, 2026, the average hourly pay for remote prior authorization in Racine, WI is $19.59, according to ZipRecruiter salary data. Most workers in this role earn between $16.25 and $21.63 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 popular job titles related to Remote Prior Authorization jobs in Racine, WI? For Remote Prior Authorization jobs in Racine, WI, the most frequently searched job titles are:
What job categories do people searching Remote Prior Authorization jobs in Racine, WI look for? The top searched job categories for Remote Prior Authorization jobs in Racine, WI are:
What cities near Racine, WI are hiring for Remote Prior Authorization jobs? Cities near Racine, WI with the most Remote Prior Authorization job openings:
Remote Prior Authorization jobs near you
Infographic showing various Remote Prior Authorization job openings in Racine, WI as of July 2026, with employment types broken down into 50% Full Time, and 50% Part Time. Highlights an 100% Remote job distribution, with an average salary of $40,751 per year, or $19.6 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 24 days ago

Froedtert South rating

6.9

Company rating: 6.9 out of 10

Based on 39 frontline employees who took The Breakroom Quiz

454th 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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