Cvs Prior Authorization Remote Jobs Near Me

Employment Type:

Full time

Shift:

Description:

Position Purpose:

• Responsible for all aspects of the authorization/pre-certification or referral process. Verifies insurance eligibility and contacts the payer to initiate pre-certification by providing supporting medical documentation, follows up with insurance on outcome of determination for all medical procedures and services in attempt to obtain a successful authorization.

• Specialty: Cardiology and Neurology

• Schedule: Monday - Friday 9:00am - 5:30pm

• Location: Remote

What You Will Do:

• Assists offices in resolving billing discrepancies and any other referral/authorization issues

• Contacts insurance companies via appropriate methods and obtains pre-certifications and authorizations.

• Obtains urgent authorizations same day, next day

• Verifies correct procedural and diagnostic codes and insurance verification.

Minimum Qualifications:

• High school diploma Must possess one (1) to three (3) years of experience with insurance referrals, prior authorizations, or other equivalent knowledge of professional revenue cycle.

• Knowledge of medical terminology and procedures at the level needed to perform responsibilities.

Position Highlights and Benefits:

• Mount Carmel Health System recognized by Forbes in 2025 as one of America's Best State Employers.

• Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one.

• Retirement savings account with employer match starting on day one.

• Generous paid time off programs.

• Employee recognition programs.

• Tuition/professional development reimbursement starting on day one.

• RN to BSN tuition 100% paid at Mount Carmel's College of Nursing.

• Relocation assistance (geographic and position restrictions apply).

• Employee Referral Rewards program.

• Mount Carmel offers DailyPay - if you're hired as an eligible colleague, you'll be able to see how much you've made every day and transfer your money any time before payday. You deserve to get paid every day!

• Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.

Ministry/Facility Information:

Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our five hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If you're seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You!

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

EOE including disability/veteran