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Remote Prior Authorization Jobs in Riverside, CA

Dragonfly Recruiting

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Utilization Management Inpatient Coordinator

Orange, CA · Remote

$23 - $26/hr

This position is fully remote and offers a contract-to-permanent hire opportunity based on ... Experience processing referrals, authorizations, or prior authorizations . * Experience working ...

The Neuron Clinic

LVN- Care Management

Murrieta, CA · On-site +1

$30 - $38/hr

Work closely with our internal Referrals and Prior Authorizations department to ensure that patient ... This is a remote position. Compensation: $30.00 - $38.00 per hour The Neuron Clinic is an evidenced ...

The Neuron Clinic

LVN- Care Management

Murrieta, CA · On-site +1

$30 - $38/hr

Work closely with our internal Referrals and Prior Authorizations department to ensure that patient ... This is a remote position. Compensation: $30.00 - $38.00 per hour The Neuron Clinic is an evidenced ...

The Neuron Clinic

LVN- Care Management

Corona, CA · On-site +1

$30 - $38/hr

Work closely with our internal Referrals and Prior Authorizations department to ensure that patient ... This is a remote position. Compensation: $30.00 - $38.00 per hour The Neuron Clinic is an evidenced ...

Cordis

Clinical Study Manager

Irvine, CA · On-site +1

$114K - $165K/yr

Prior experience with IDE and PMA submissions. * Familiarity with risk-based monitoring, EDC, eTMF ... Remote-based * Occasional domestic and international travel for investigator meetings, site visits ...

Cordis

Clinical Study Manager

Irvine, CA · On-site +1

$114K - $165K/yr

Prior experience with IDE and PMA submissions. * Familiarity with risk-based monitoring, EDC, eTMF ... Remote-based * Occasional domestic and international travel for investigator meetings, site visits ...

Only Data Entry

Remote Customer Service

Murrieta, CA · Remote

$16.25 - $22.25/hr

Remote Customer Service Murrieta, CA, United States Job Openings Remote Customer Service A Data Entry Clerk, is responsible for inputting data and making changes to existing data figures in digital ...

3M

3M Packaging Specialist - Southern California

Anaheim, CA · On-site +1

$113K - $139K/yr

Bachelor's degree or higher (completed and verified prior to start) from an accredited institution ... Remote - Los Angeles or Orange County Territory: Southern California Travel: May include up to 50 ...

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All JobsRemote Prior Authorization JobsRemote Prior Authorization Jobs in Riverside, CA

Remote Prior Authorization information

See Riverside, CA salary details

$14

$21

$33

How much do remote prior authorization jobs pay per hour?

As of Jun 10, 2026, the average hourly pay for remote prior authorization in Riverside, CA is $21.80, according to ZipRecruiter salary data. Most workers in this role earn between $18.08 and $24.09 per hour, depending on experience, location, and employer.

What are remote prior authorization jobs?

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 Are Remote Prior Authorization Jobs?

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 Riverside, CA? The most popular types of Prior Authorization jobs in Riverside, CA are:
What are popular job titles related to Remote Prior Authorization jobs in Riverside, CA? For Remote Prior Authorization jobs in Riverside, CA, the most frequently searched job titles are:
What job categories do people searching Remote Prior Authorization jobs in Riverside, CA look for? The top searched job categories for Remote Prior Authorization jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Remote Prior Authorization jobs? Cities near Riverside, CA with the most Remote Prior Authorization job openings:
Remote Prior Authorization jobs near you
Infographic showing various Remote Prior Authorization job openings in Riverside, CA as of June 2026, with employment types broken down into 75% Full Time, 17% Part Time, and 8% Contract. Highlights an 8% In-person, and 92% Remote job distribution, with an average salary of $45,340 per year, or $21.8 per hour.
Utilization Management Inpatient Coordinator

Utilization Management Inpatient Coordinator

Dragonfly Recruiting

Orange, CA • Remote

$23 - $26/hr

Full-time

Medical, Dental, PTO

Posted 11 days ago

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Job description

Utilization Management Coordinator – Inpatient Review (Health Plan)

Remote | Contract-to-Permanent Hire | Medicare Advantage

We are seeking an experienced Utilization Management Coordinator – Inpatient Review to support a Health Plan Care Management team. This role supports inpatient, and skilled nursing facility (SNF) utilization review workflows, including census tracking, admissions coordination, medical record collection, transition of care and concurrent review support.

The ideal candidate has health plan experience supporting inpatient review or care management, strong documentation skills, and experience working with referrals, authorizations, and Medicare Advantage populations.

This position is fully remote and offers a contract-to-permanent hire opportunity based on performance and business needs.

Schedule: Monday–Friday, 8:00 AM – 5:00 PM PST
Employment Type: Contract-to-Hire
Location: Remote (must work Pacific Time hours). May reside in any state.

Key Responsibilities

  • Maintain and update daily inpatient and skilled nursing facility census activity.
  • Enter and manage inpatient referrals, authorizations, and member information within health plan systems.
  • Obtain and upload hospital and SNF medical records for concurrent utilization review.
  • Support Utilization Management nurses and case managers by gathering documentation for inpatient concurrent review.
  • Track member admissions, transfers, and discharges and communicate updates to the care management team.
  • Communicate with hospital utilization review departments, case managers, and facility staff regarding documentation and member status.
  • Enter and review ICD-10 and CPT codes related to inpatient referrals and authorizations.
  • Maintain detailed documentation of facility outreach and care coordination activities.
  • Ensure compliance with HIPAA and health plan documentation standards.
  • Assist nurses and case managers with urgent requests and time-sensitive workflows.

Required Qualifications

  • 1–2+ years of Utilization Management Coordinator experience within a Health Plan.
  • Experience supporting inpatient concurrent review or inpatient utilization management workflows.
  • Experience processing referrals, authorizations, or prior authorizations.
  • Experience working with Medicare Advantage members.
  • Basic understanding of medical terminology, ICD-10 codes, CPT codes, and diagnostic coding.
  • Ability to work within multiple health plan systems and provider portals.
  • Strong organizational, documentation, and communication skills.

Preferred Qualifications

  • Experience supporting discharge planning coordination.
  • Familiarity with managed care models (Medicare Advantage, HMO, PPO/MMO).
  • Experience working with hospital admissions departments or utilization review teams.
  • Experience with Epic or provider portals such as Access Express.

Required Skills

  • Microsoft Outlook, Excel, and Word
  • Typing speed of 50+ WPM
  • Strong attention to detail and organizational skills
  • Ability to manage multiple systems and high-volume documentation
  • Strong verbal, written, and phone communication skills

Education

High School Diploma or GED required.

Equal Opportunity Employer

We are an Equal Opportunity Employer and welcome applicants from all backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability, veteran status, age, or any other protected status under applicable law

Company Description

Dragonfly Recruiting was founded with a vision to revolutionize the staffing industry. From our humble beginnings, we have grown into a trusted partner for businesses and job seekers alike. Our journey began with a small team of passionate recruiters who believed in the power of personalized service and the importance of building strong relationships.
Recently, we have expanded our services and our team, always staying true to our core values of integrity, excellence, and commitment to quality. Our growth has been driven by our dedication to understanding the unique needs of our clients and candidates, and our ability to adapt to the ever-changing landscape of the job market.
Dragonfly Recruiting is proud to be a leader in the staffing industry, known for our innovative solutions and our unwavering commitment to helping businesses and individuals achieve their goals.