Top 538 Remote authorization Jobs in Florida

Care Review Clinician (RN) - Remote in FL
Molina Healthcare, Inc. —Florida
- $26.41 - $51.49 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
Care Review Clinician (RN) - Remote in FL
Molina Healthcare, Inc. —Miami, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
Medical Records Specialist - Mental Health/ Behavioral Health - Remote contract
Pro Med Healthcare Services —Florida
- $20 - $22 an hour
- Full-time
- Remote
- CPR Certification
- Current TB test
- BLS Certification
Quick Apply
1d
Insurance Verification Specialist Behavioral Health- Remote Contract
Pro Med Healthcare Services —Florida
- Full-time
- Remote
- Customer service
- Mid-level
- 3 years
Quick Apply
1d
Medical Biller - Remote
Orthos Inc —Florida
- Full-time
- Remote
- Mid-level
- Organizational skills
- Communication skills
Quick Apply
Medicaid Eligibility Advocate
HCA Florida Trinity Hospital —Trinity, FL
- Full-time
- Remote
- Reliable transportation
- Entry level
- Employee stock purchase plan
- Disability insurance
Quick Apply
Utilization Review Specialist
We Level Up —Pompano Beach, FL
- $50,000 - $90,000 a year
- Full-time
- Remote
- 18 years or older
- CPR Certification
- HIPAA
Quick Apply
Referral & Authorization Care Coordinator
Oshi Health —Miami, FL
- $47,000 - $52,000 a year
- Email
- Remote
- Nursing
- Data analysis skills
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
14d
Medicaid Eligibility Advocate
HCA Florida Brandon Hospital —Brandon, FL
- Full-time
- Remote
- Reliable transportation
- Entry level
- Employee stock purchase plan
- Disability insurance
Quick Apply
Insurance Verification & Authorization Specialist – Remote
FYZICAL LLC —Bradenton, FL
- $17 - $19 an hour
- Full-time
- Remote
- Microsoft Outlook
- Addiction Medicine
- Mid-level
- Paid holidays
- Disability insurance
Quick Apply
Contact Center Associate 1 - UHealth Connect (Remote)
University of Miami —Medley, FL
- Full-time
- Remote
- Spanish
- Computer literacy
- HIPAA
- Health insurance
- Dental insurance
Pharmacy Care Representative - Work From Home Florida (Active Pharmacy Technician License Needed)
CVS Health —Florida
- $17.00 - $28.46 an hour
- Overtime
- Remote
- Microsoft Outlook
- Windows
- High school diploma or GED
- Paid holidays
- Health insurance
AI Training Generalist (No Prior Experience Needed) - Freelance AI Trainer Project
Meridial —Miami, FL
- $20 an hour
- Remote
- No experience needed
- US work authorization
- Entry level
Utilization Review Specialist (Remote)
Coronis Health —Delray Beach, FL
- $60,000 - $62,000 a year
- Full-time
- Remote
- LMFT
- Management
- Addiction Medicine
Quick Apply
13d
Insurance Verification Representative - Remote (Tri-County Area)
University of Miami —Medley, FL
- Full-time
- Remote
- Bilingual
- Computer literacy
- Mid-level
- Health insurance
- Dental insurance
Referral Services Representative - Winter Garden/Remote After 90 Days
Community Health Centers, Inc. —Winter Garden, FL
- Full-time
- Remote
- Medical office experience
- HIPAA
- High school diploma or GED
- Paid holidays
- Health insurance
Support Specialist I
Allsup Employment Services —Orlando, FL
- $33,280 - $40,000 a year
- Full-time
- Remote
- Communication skills
- Entry level
- Health savings account
- Paid holidays
Quick Apply
14d
Clinical Business Operations Specialist - Remote
University of Miami —Hialeah, FL
- Full-time
- Remote
- Mid-level
- 3 years
- High school diploma or GED
- Health insurance
- Dental insurance
Clinical Administrative Coordinator
UnitedHealthcare —Tampa, FL
- $18 - $32 an hour
- 8 hour shift
- Remote
- 18 years or older
- Microsoft Outlook
- Pass drug screening
- AD&D insurance
- Employee stock purchase plan
7d
Utilization Review Nurse
Cobalt Benefits Group LLC —Orlando, FL
- $90,000 - $98,000 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- Microsoft Outlook
- Health savings account
- AD&D insurance
Quick Apply

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remote authorization jobs near florida

Care Review Clinician (RN) - Remote in FL

Molina Healthcare, Inc. -
Florida

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Job Details

Full-time
$26.41 - $51.49 an hour

Benefits

Health insurance

Qualifications

Inpatient experience
RN License
Managed care organization experience
Acute care facility experience
Pre-authorization review for utilization management
Productivity software

Full Job Description

JOB DESCRIPTION

Must reside in Florida

Job Summary

Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines.
Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
Conducts reviews to determine prior authorization/financial responsibility for Molina and its members.
Processes requests within required timelines.
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner.
Requests additional information from members or providers as needed.
Makes appropriate referrals to other clinical programs.
Collaborates with multidisciplinary teams to promote the Molina care model.
Adheres to utilization management (UM) policies and procedures.

Required Qualifications

At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
Registered Nurse (RN). License must be active and unrestricted in state of practice.
Ability to prioritize and manage multiple deadlines.
Excellent organizational, problem-solving and critical-thinking skills.
Strong written and verbal communication skills.
Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications

Certified Professional in Healthcare Management (CPHM).
Recent hospital experience in an intensive care unit (ICU) or emergency room.

Utilization Management (UM) experience highly preferred.

#PJHS3

#LI-AC1

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Apply Now

Refine Your Search

remote authorization jobs in florida

Care Review Clinician (RN) - Remote in FL

Care Review Clinician (RN) - Remote in FL

Medical Records Specialist - Mental Health/ Behavioral Health - Remote contract

Insurance Verification Specialist Behavioral Health- Remote Contract

Medical Biller - Remote

Medicaid Eligibility Advocate

Utilization Review Specialist

Referral & Authorization Care Coordinator

Medicaid Eligibility Advocate

Insurance Verification & Authorization Specialist – Remote

Contact Center Associate 1 - UHealth Connect (Remote)

Pharmacy Care Representative - Work From Home Florida (Active Pharmacy Technician License Needed)

AI Training Generalist (No Prior Experience Needed) - Freelance AI Trainer Project

Utilization Review Specialist (Remote)

Insurance Verification Representative - Remote (Tri-County Area)

Referral Services Representative - Winter Garden/Remote After 90 Days

Support Specialist I

Clinical Business Operations Specialist - Remote

Clinical Administrative Coordinator

Utilization Review Nurse

I want to receive the latest job alert for remote authorization in florida

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