Top 179 Remote prior authorization Jobs in North Carolina

Authorization and Appeals Specialist
The Palomino Group —North Carolina
- From $23 an hour
- Full-time
- Background check
- Microsoft Excel
- Microsoft Outlook
- Disability insurance
- Health insurance
Quick Apply
8d
Authorization Specialist
Carolina Oncology Specialists —Charlotte, NC
- Full-time
- Customer service
- Mid-level
- High school diploma or GED
Quick Apply
6d
Field Auto Appraiser - North Carolina
National General —Winston-Salem, NC
- $21.20 - $50.24 an hour
- Online Application
- Customer service
- Mid-level
- Analysis skills
- Work from home
Field Auto Appraiser
National General —Raleigh, NC
- $21.20 - $50.24 an hour
- Online Application
- Mid-level
- US work authorization
- Fair chance
- Work from home
Care Manager - LP (Haywood County, NC)
Vaya Health —Clyde, NC
- $62,993.84 - $75,000.00 a year
- LMFT
- Nursing
- Microsoft Excel
Care Manager - LP (Henderson County, NC)
Vaya Health —North Carolina
- $62,993.84 - $75,000.00 a year
- Full-time
- LMFT
- Nursing
- Microsoft Excel
AI Solutions Consulting Lead
Crowe —Charlotte, NC
- $102,400 - $204,100 a year
- Full-time
- Azure
- Computer Science
- Engineering
Quick Apply
Admissions Coordinator & Authorization/UR Specialist
Joshua Tree Health —Apex, NC
- Full-time
- Hybrid work
- Medical office experience
- HIPAA
- 3 years
Quick Apply
Remote Processing Specialist
CLEAResult Consulting Inc. —Raleigh, NC
- $16 an hour
- Full-time
- Remote
- US work authorization
- Organizational skills
- Entry level
- Health insurance
- Dental insurance
Quick Apply
Advanced Imaging Authorization Specialist
Raleigh Orthopaedic Clinic —Raleigh, NC
- Full-time
- Hybrid work
- Mid-level
- 2 years
- Health savings account
- Health insurance
Quick Apply
AI Training Generalist (No Prior Experience Needed) - Freelance AI Trainer Project
Meridial —Charlotte, NC
- $20 an hour
- Remote
- No experience needed
- US work authorization
- Entry level
Care Manager I-Non-Waiver (Full Time, Hybrid, Mecklenburg County, North Carolina Based)
Alliance Health —Charlotte, NC
- $28.96 - $37.65 an hour
- Full-time
- Hybrid work
- LMFT
- Nursing
- Microsoft Excel
- Disability insurance
- Health insurance
1d
Care Manager I-Non-Waiver (Full Time, Hybrid, Harnett County, North Carolina Based)
Alliance Health —Morrisville, NC
- $28.96 - $37.65 an hour
- Full-time
- Hybrid work
- LMFT
- Nursing
- Microsoft Excel
- Disability insurance
- Health insurance
1d
Billing and Administrative Assistant
Sacred Roots Group PLLC —White Oak, NC
- $18 - $25 an hour
- Part-time
- Hybrid work
- HIPAA
- Office
- Administrative experience
- Health insurance
- Dental insurance
Quick Apply
12d
Patient Care Specialist
Sentara Albemarle Regional Medical Center, LLC —Elizabeth City, NC
- Full-time
- Mid-level
- 3 years
- High school diploma or GED
- 403(b) matching
- Paid parental leave
Quick Apply
Cornea Reimbursement Liaison - Charlotte, NC | Charleston, WV | Columbia, SC | Richmond, VA
Glaukos —Charlotte, NC
- $143,400 - $179,200 a year
- Full-time
- Background check
- Up to 50% travel
- Customer service
Quick Apply
12d
Analyst II - Crisis Management
Ally Financial —Charlotte, NC
- $55,000 - $95,000 a year
- 8 hour shift
- Hybrid work
- Microsoft Word
- Mid-level
- Office
- Paid parental leave
- Health savings account
AVP Commercial Credit Officer II (Remote)
The Bancorp, Inc. —Morrisville, NC
- $65,957 - $113,340 a year
- Full-time
- Remote
- Background check
- Microsoft Excel
- Microsoft Outlook
Transportation Security Officer
US Transportation Security Administration —Raleigh, NC
- $42,538 - $59,360 a year
- Overtime
- Background check
- 18 years or older
- Ability to walk for extended periods
- Travel reimbursement
- Paid holidays
6d
Remote Bilingual Customer Support Specialist
CLEAResult Consulting Inc. —Raleigh, NC
- $18.75 an hour
- Full-time
- Remote
- Spanish
- Sales
- English
- Health insurance
- Dental insurance
Quick Apply

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remote prior authorization jobs near north carolina

Authorization and Appeals Specialist

The Palomino Group
North Carolina

Quick Apply

Job Details

Full-time
From $23 an hour
8 days ago

Benefits

Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
Life insurance

Qualifications

Health insurance authorizations
Appeals
Microsoft Excel
Overseeing health insurance pre-certification
Medicare
Phone communication
Medical insurance coverage verification
HIPAA
Administrative experience
Medicaid health insurance
ICD-10
HCPCS
Phone customer support
Case appeal in utilization management
Attention to detail
Health information regulatory compliance
Medical insurance appeals management
Organizational skills
Medicaid
Clinical confidentiality policies
Insurance claims appeal handling
Medical terminology
Technical Proficiency

Full Job Description

Overview

The Authorization & Appeals Specialist will be responsible for conducting benefit and coverage verifications, obtaining authorizations, and supporting the appeal process for medical device procedures. The position will work as part of a reimbursement support team to obtain approval for patient procedures and will mainly interact with health insurance plans, healthcare providers in the physician practice and hospital outpatient settings, and patients. This position requires outstanding knowledge of the reimbursement process associated with outpatient medical procedures, including medical devices. This position requires exceptional written and verbal communication skills with healthcare providers and payers in addition to excellent customer service phone skills. Experience working within portals regarding the digital reimbursement setting is preferred.

A MINIMUM OF 3 YEARS OF AUTHORIZATION AND APPEALS SUPPORT EXPERIENCE REQUIRED.

Responsibilities

The Authorization & Appeals Specialist is responsible for coordinating the reimbursement process for medical device procedures and will work closely with health insurance companies, healthcare providers, and patients. This position requires frequent interaction with healthcare provider teams and requires demonstration of past work success within this or similar environments. Job duties include managing all aspects of the reimbursement and access process, including benefit and coverage verification, prior authorization, and appeals.

The Authorization & Appeals Specialist must be able to:

Understand insurance company processes pertaining to gaining authorization of treatment
Verify medical insurance benefits, including the ability to obtain and process payer forms
Provide information pertaining to claims, including billing and coding assistance
Coordinate authorization for medical device procedures with payer authorization departments
Support the various levels of appeal for denied authorizations or claims
Effectively communicate with healthcare providers on case status
Appropriately answer incoming calls, faxes, and emails through our reimbursement call center
Document all interactions and calls within a case management database
Maintain HIPAA compliance at all times
Expertly translate clinical information into a form letter
Work independently or within a team setting
Provide services in a high-volume and stressful work environment

Required Skill Set

The Authorization & Appeals Specialist must have prior experience in conducting authorizations and appeals for medical procedures and must possess the relevant knowledge of these processes across all payer types, including commercial and public health insurance plans.

Required skills include:

Prior success as an authorization and appeals specialists within the healthcare arena
Outstanding customer service skills (including clarity of voice, tone, empathy, and listening skills)
High level of Professionalism
Strong critical thinking and decision-making skills
Superior written communication skills
Excellent administrative skills
Ability to adapt to different situations
Strong organizational skills
Self-motivation with excellent follow-through skills
Ability to work independently with minimal-to-moderate supervision
Adaptive and flexible to new ideas and change
Proven/demonstrated knowledge of medical reimbursement methodologies
Understanding of HIPAA and legal requirements associated with health information
Fluency in medical terminology

Minimum Qualifications and Experience

3 years of experience conducting benefit and coverage verifications with health insurance plans
3 years of experience in conducting authorizations for medical procedures
3 years of experience in conducting appeals for medical procedures
3 years of health insurance experience working with HCPCS, CPT, ICD-10 codes
Demonstrated familiarity with all payer types (Medicare, Medicaid, Commercial, etc.)
Knowledge of medical procedures, including medical devices used in the outpatient setting
Associate degree or equivalent work experience
Technical Expertise: Working knowledge of Microsoft Office (Word, Excel, Outlook)

If you thrive in a detail-oriented environment with a passion for healthcare authorization and appeals administration, we invite you to bring your skills and enthusiasm to our team!

Pay: From $23.00 per hour

Benefits:

401(k)
Dental insurance
Disability insurance
Health insurance
Life insurance
Paid time off
Vision insurance

Work Location: Remote

Quick Apply

Refine Your Search

remote prior authorization jobs in north carolina

Authorization and Appeals Specialist

Authorization Specialist

Field Auto Appraiser - North Carolina

Field Auto Appraiser

Care Manager - LP (Haywood County, NC)

Care Manager - LP (Henderson County, NC)

AI Solutions Consulting Lead

Admissions Coordinator & Authorization/UR Specialist

Remote Processing Specialist

Advanced Imaging Authorization Specialist

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

Care Manager I-Non-Waiver (Full Time, Hybrid, Mecklenburg County, North Carolina Based)

Care Manager I-Non-Waiver (Full Time, Hybrid, Harnett County, North Carolina Based)

Billing and Administrative Assistant

Patient Care Specialist

Cornea Reimbursement Liaison - Charlotte, NC | Charleston, WV | Columbia, SC | Richmond, VA

Analyst II - Crisis Management

AVP Commercial Credit Officer II (Remote)

Transportation Security Officer

Remote Bilingual Customer Support Specialist

I want to receive the latest job alert for remote prior authorization in north carolina

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