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Remote Prior Authorization Analyst Jobs Near Me

Gifthealth

Lead Reimbursement Analyst

Columbus, OH · On-site

$31.47 - $39.34/hr

... prior authorizations, appeals, and patient assistance programs; manage and resolve escalated cases ... Remote; desk-based role with frequent phone and computer use and minimal physical requirements

Gifthealth Inc

Lead Reimbursement Analyst

Columbus, OH · Remote

$31.47 - $39.34/hr

... prior authorizations, appeals, and patient assistance programs; manage and resolve escalated cases ... Remote; desk-based role with frequent phone and computer use and minimal physical requirements

Pharmacy Careers

Formulary Management Pharmacist

Columbus, OH · On-site

$54.50 - $65.50/hr

... Remote Friendly Shape which medications patients can access by evaluating new drugs, analyzing ... Provide clinical support for utilization management, prior-authorization criteria, and step-therapy ...

MCKESSON

Field Reimbursement Manager

Springfield, OH · On-site +1

... Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client ...

RXinsider LTD.

Field Reimbursement Manager

Columbus, OH · On-site

$80 - $134/hr

... Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client ...

MCKESSON

Field Reimbursement Manager

Columbus, OH · On-site +1

... Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client ...

Huntington

Sr. Data Observability Analyst

Columbus, OH · On-site +1

$80K - $101K/yr

... prior development experience in modern development languages. * 2 years prior development ... Remote roles will also have the opportunity to come together in our offices for moments that matter.

New

Huntington

Sr. Data Observability Analyst

Columbus, OH · On-site +1

$80K - $101K/yr

... roles. 2 years prior development experience in modern development languages. 2 years prior ... Remote roles will also have the opportunity to come together in our offices for moments that matter.

New

Huntington

Sr. Data Observability Analyst

Columbus, OH · On-site +1

$83K - $104K/yr

... prior development experience in modern development languages. * 2 years prior development ... Remote roles will also have the opportunity to come together in our offices for moments that matter.

New

Huntington

Collateral Analyst Sr

Columbus, OH · On-site +1

$27.40 - $62.50/hr

Prior ABL, Commercial Banking experience or Accounting experience #LI-DK1 #CML Exempt Status: (Yes ... Remote roles will also have the opportunity to come together in our offices for moments that matter.

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How much do remote prior authorization analyst jobs pay per year?

As of Aug 28, 2026, the average yearly pay for remote prior authorization analyst in the United States is $73,261.00, according to ZipRecruiter salary data. Most workers in this role earn between $52,500.00 and $87,000.00 per year, depending on experience, location, and employer.

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Remote Prior Authorization Analyst jobs near you
A map of the United States highlighting the number of Remote Prior Authorization Analyst job openings by state according to ZipRecruiter. The image is accompanied by a detailed chart listing the number of Remote Prior Authorization Analyst job openings in each state, with California having the most at 2 and Hawaii the least at 0.

Lead Reimbursement Analyst

Gifthealth

Columbus, OH • On-site

$31.47 - $39.34/hr

Full-time

This job post has expired 2 days ago. Applications are no longer accepted.

Gifthealth rating

7.7

Company rating: 7.7 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

20th of 113 rated pharmacies

Job description

About Us
At Gifthealth, we're revolutionizing the way people experience healthcare by simplifying the process of managing prescriptions and health services. Our mission is to provide a seamless, personalized, and efficient healthcare experience for all our customers. We're a dynamic, innovative, and customer-centric company dedicated to making a positive impact on people's lives.
Position Summary
The Lead Reimbursement Analyst serves as a working team lead within the reimbursement organization, combining advanced reimbursement expertise with direct people leadership responsibilities. This role manages a team of Reimbursement Analysts while maintaining ownership of complex reimbursement cases, escalations, quality initiatives, and operational performance. The Lead Reimbursement Analyst is responsible for coaching, developing, and supporting team members, ensuring adherence to client requirements, quality standards, and service level expectations. This role partners closely with leadership to drive operational excellence, employee engagement, and continuous process improvement. This is a fully remote, desk-based role with frequent phone and computer use.
Requirements
Key Responsibilities
  • Advanced Reimbursement & Case Management Serve as the primary point of contact for moderate to complex reimbursement cases including insurance benefit investigations, prior authorizations, appeals, and patient assistance programs; manage and resolve escalated cases requiring advanced research, payer interaction, or clinical coordination; review and resolve denied or underpaid claims; research and apply payer medical policies, prior authorization requirements, and coverage guidelines; identify patient-specific insurance coverage options; reverify patient benefits at predetermined timeframes and document all activities within required timelines
  • Leadership, Mentorship & Quality Support Provide direct supervision, coaching, and performance management for a team of Reimbursement Analysts, including goal setting, performance feedback, and employee development; conduct regular one-on-one meetings, performance discussions, and career development planning; support recruiting, interviewing, onboarding, and training of new team members; monitor team productivity, quality, and service level metrics and implement corrective actions as needed; serve as the primary escalation point for complex reimbursement cases and operational issues; act as a subject matter expert and resource for reimbursement workflows, payer policies, and client requirements; identify trends in errors, denials, or workflow inefficiencies and implement solutions to improve team performance; assist with drafting, maintaining, and communicating SOPs, work instructions, and quality standards; foster a positive, collaborative, and accountable team environment.
  • Client & Cross-Functional Support Serve as a point of contact for internal teams and external stakeholders including payers, healthcare providers, patients, and client representatives; may act as a regional or program-specific contact for senior-level client contacts; assist with coordination of tasks and communication between Gifthealth, clients, and internal partners; prepare or assist with preparation of internal and client-facing reports including adverse event and product complaint documentation as required
  • Operational Support Monitor and communicate updates related to payer policies, coverage changes, and prior authorization requirements; assist in testing and feedback for CRM, telephony, and system tools related to reimbursement workflows; participate in client calls, meetings, off-site trainings, and conferences as needed; travel estimated at up to 5%

Qualifications
Education
  • Bachelor's degree or equivalent relevant experience (Required)

Experience
  • Minimum 4 years of recent healthcare/medical & billing experience with at least 1-2 years of leadership, supervisory, team lead, or people management experience preferred (Required)
  • 2 years of direct reimbursement, specialty pharmacy, hub services, or patient support program experience preferred (Required)
  • Call center experience, client interaction experience, and experience leading or mentoring team members (Preferred)
  • Active Pharmacy Technician Trainee license or ability to obtain one within 90 days of hire (Required)

Knowledge, Skills & Abilities
  • Advanced knowledge of medical insurance (public and commercial), billing and coding, and associated terminology (Required)
  • Advanced written and verbal communication skills; strong customer service skills; demonstrated ability to collaborate cross-functionally and escalate issues appropriately (Required)
  • High attention to detail with strong data entry accuracy; advanced problem-solving, research, and analytical skills (Required)
  • Ability to manage time independently, prioritize workload, and multitask in a fast-paced environment; proficiency in Microsoft Office Suite (Required)

Work Environment
  • Location: Remote; desk-based role with frequent phone and computer use and minimal physical requirements
  • Schedule: Monday through Friday, 8:00 AM to 8:00 PM EST (40 hours/week); shift start times may range from 8:00 AM to 11:00 AM EST; occasional weekend hours may be required to support client needs
  • Works closely with Reimbursement Analysts, Supervisors, and Program Managers; maintains direct contact with healthcare providers, patients, payers, and client representatives

Employment Classification
Status: Full-time
FLSA: Non-Exempt
Equal Employment Opportunity (EEO) Statement
Gifthealth is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. All employment decisions are made without regard to race, color, religion, sex, sexual orientation, gender identity, transgender status, national origin, age, disability, veteran status, or any other legally protected status.
Disclaimer
This job description is intended to describe the general nature and level of work being performed. It is not intended to be an exhaustive list of all responsibilities, duties, or skills required of personnel. Gifthealth reserves the right to modify job duties or descriptions at any time.
Salary Description
$31.47 - $39.34

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