Top 218 Prior authorization specialist work from home Jobs in Remote

Prior Authorization Specialist I
Boston Medical Center —Remote
- $25.42 - $30.97 an hour
- Part-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- High school diploma or GED
- Health insurance
- Dental insurance
8d
Insurance Authorization Specialist II
SYSTEM West Virginia University Health System —Remote
- Full-time
- Remote
- Microsoft Outlook
- Computer literacy
- Basic math
Prior Authorization Specialist - Required EPIC
Valerion Health —Remote
- Full-time
- Remote
- Microsoft Excel
- Urgent Care
- Mid-level
- Health insurance
Quick Apply
7d
Authorization Specialist - Revenue Cycle Management
Vital Care Infusion Services —Remote
- $18.92 - $23.46 an hour
- Full-time
- Remote
- Writing skills
- English
- Mid-level
- Health savings account
- Paid holidays
Quick Apply
Revenue Cycle Authorization Specialist
Retina Consultants of America —Remote
- From $22 an hour
- Full-time
- Remote
- Background check
- Microsoft Excel
- Microsoft Outlook
- Health savings account
- Disability insurance
Quick Apply
Referral Authorization Specialist
Samaritan —Washington, DC
- $21.24 - $28.84 an hour
- Full-time
- Remote
- Heavy lifting
- HIPAA
- Mid-level
Quick Apply
Prior Authorization Specialist
RAYUS Radiology —Indianapolis, IN
- Full-time
- Remote
- Bilingual
- Computer literacy
- HIPAA
- Paid holidays
- Disability insurance
Quick Apply
10d
Authorization Specialist
The Centers for Advanced Orthopaedics LL —Baltimore, MD
- Remote
- English
- Mid-level
- High school diploma or GED
Quick Apply
ROI Medical Records Specialist - Remote
Sharecare —Remote
- Full-time
- Remote
- Microsoft Word
- Microsoft Excel
- HIPAA
Insurance Verification & Authorization Specialist – Remote
FYZICAL LLC —Lexington, SC
- $17 - $19 an hour
- Full-time
- Remote
- Microsoft Outlook
- Addiction Medicine
- Mid-level
- Paid holidays
- Disability insurance
Quick Apply
Intake Specialist - Revenue Cycle Management
Vital Care Infusion Services —Remote
- $18.92 - $23.46 an hour
- Full-time
- Remote
- Writing skills
- English
- Mid-level
- Health savings account
- Paid holidays
Quick Apply
Surgical Authorization Specialist- Remote
The CORE Institute | HOPCo —Phoenix, AZ
- Remote
- Microsoft Outlook
- Surgery
- Computer literacy
Quick Apply
8d
Remote LTC Pharmacy Billing Specialist (FrameworkLTC experience)
Pharmacy Recruiting LLC. —Remote
- $18 - $24 an hour
- Full-time
- Remote
- Anatomy knowledge
- Customer service
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
4d
Sr. Reimbursement Specialist
United Biosource Corporation —Remote
- Full-time
- Remote
- Computer literacy
- No high school diploma
- Mid-level
- Wellness program
- Health savings account
6d
Insurance Verification Specialist - 3147/Remote - Full Time
Wilmington Health PLLC —Wilmington, NC
- Full-time
- Remote
- HIPAA
- High school diploma or GED
- Organizational skills
PRN Insurance Specialist
RAYUS Radiology —Portland, OR
- Part-time
- Remote
- Bilingual
- Computer literacy
- HIPAA
- Paid holidays
- Disability insurance
Quick Apply
PAHub & Prior Authorization Specialist
Agadia Systems Inc —Parsippany-Troy Hills, NJ
- $60,000 - $200,000 a year
- Full-time
- Remote
- 5 years
- HIPAA
- Analysis skills
Quick Apply
5d
Acute Clearance Specialist - Intake Coordinator - Remote
Soleo Health Inc —Frisco, TX
- $23 - $27 an hour
- Urgently hiring
- Remote
- Microsoft Word
- HIPAA
- Mid-level
- Paid parental leave
- Health savings account
Quick Apply
7d
Senior Claims Auditor - DRG
Cohere Health —Remote
- $85,000 - $100,000 a year
- Remote
- Nursing
- 6 years
- HIPAA
- Paid parental leave
- Health savings account
Quick Apply
Insurance Eligibility & Follow-Up Specialist (Remote)
GetixHealth —Tacoma, WA
- $16 - $20 an hour
- Overtime
- Remote
- HIPAA
- Mid-level
- High school diploma or GED
- AD&D insurance
- Disability insurance
Quick Apply

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Prior Authorization Specialist I

Boston Medical Center -
Remote

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Job Details

Part-time
$25.42 - $30.97 an hour
8 days ago

Benefits

Health insurance
Dental insurance
Flexible spending account
Paid time off
Vision insurance
403(b)
Opportunities for advancement

Qualifications

Microsoft Excel
Microsoft Outlook
High school diploma or GED

Full Job Description

Prior Authorization Specialist I

49281

Remote, United States

Part time

POSITION SUMMARY:

The Inpatient Verification Specialist role belongs to the Revenue Cycle Patient Access team and is responsible for coordinating all financial clearance activities by navigating all referral, precertification, and/or authorization requirements as outlined in payer-specific guidelines and regulations. The role plays an important dual role by helping to coordinate patient access to care while maximizing BMC hospital reimbursement. This role requires adherence to quality assurance guidelines as well as established productivity standards to support the work unit’s performance expectations. This position reports to the Patient Access Supervisor and requires interaction and collaboration with important stakeholders in the financial clearance process including but not limited to insurance company representatives, patients, physicians, Boston Medical Center (BMC) practice staff, case management and inpatient financial counselors.

Position: Prior Authorization Specialist I

Department: Insurance Verification

Schedule: Part Time (M-F 10:30A-5P)

ESSENTIAL RESPONSIBILITIES / DUTIES:

Monitors accounts routed to precertification and prior authorization work queues and clears work queues by obtaining all payer specific financial clearance requirements in accordance with established management guidelines.
Maintains knowledge of and complies with insurance companies’ requirements for obtaining pre-certifications/prior authorizations/referrals, and completes other activities to facilitate all aspects of financial clearance.
Acts as subject matter experts in navigating both the BMC Community and the payer world to get the right “permissions” (authorizations, pre-certs, referrals, for example) for the care plan to proceed.
The Impatient Verification Specialist is an important part of the larger team and helps clinicians understand what payer requirements are necessary for the widest possible patient access to services.
Supports BMC staff at all levels for hands-on help understanding and navigating financial clearance issues.
Uses appropriate strategies to underscore the most efficient process to obtaining authorizations, including on line databases, electronic correspondence, faxes, and phone calls.
Obtains and clearly documents all pre-certifications/prior authorizations for scheduled services prior to admission within the Epic environment.
Collaborates with patients, providers, and departments to obtain all necessary information and payer permissions prior to patients’ scheduled services.
Communicates with patients, providers, and other departments such as Utilization Review to resolve any issues or problems with obtaining required pre-certifications/prior authorizations.
Escalates emergent and elective accounts that have been denied or will not be financially cleared within 3 days of admission as outlined by department policy
Keeps current on CMS requirements and guidelines.
Coordinates with patients and Patient Financial Counseling to initiate/process Charity Care applications as needed.
Maintains confidentiality of patient’s financial and medical records: adheres to the State and Federal laws regulating collection in healthcare, adheres to enterprise and other regulatory confidentiality policies and advises management of any potential compliance issues immediately.
Participates in educational offerings sponsored by BMC or other development opportunities as assigned/available and complies with all applicable organizational workflows, as well as established policies and procedures.
Performs other duties as assigned by Management.
Demonstrates knowledge & skills necessary to provide level of customer experience as aligned with BMC management expectations.
Demonstrates the ability to recognize situations that require escalation to the Supervisor.
Establishes relationships and effectively collaborates with revenue cycle staff to support continuous improvement aligned with BMC management expectations as outlined.
Takes opportunity to know and learn other roles and processes, and works together to assist with process improvement initiatives as directed.
Consistently meets productivity and quality expectations to align performance with assigned roles and responsibilities.
Must adhere to all of BMC’s RESPECT behavioral standards.

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).

JOB REQUIREMENTS

EDUCATION:

High School Diploma or GED required, Associates degree or higher preferred.

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

Case manager and/or coding certification desirable

EXPERIENCE:

4-5 years medical billing/denials/coding/and/or inpatient admitting experience desirable

KNOWLEDGE AND SKILLS:

General knowledge of healthcare terminology and CPT-ICD10 codes.
Complete understanding of insurance is preferred.
Requires excellent verbal communication skills, and the ability to work in a complex environment with varying points of view.
Must be comfortable with ambiguity, exhibit good decision making and judgment capabilities, attention to detail.
Knowledge of and experience within Epic is preferred.
Demonstrates technical proficiency within assigned Epic work queues and applicable ancillary systems, including but not limited to: ADT/Prelude/Grand Central, HB & PB Resolute.
Demonstrates proficiency in Microsoft Suite applications, specifically Excel, Word, and Outlook.
Displays a thorough knowledge of various sections within the work unit in order to provide assistance and back-up coverage as directed.
Displays a deep understanding of Revenue Cycle processes and applies knowledge to meet and maintain productivity standards as outlined by Management.

Compensation Range:

$25.42- $30.97

This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, and licensure/certifications directly related to position requirements. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), contract increases, Flexible Spending Accounts, 403(b) savings matches, earned time cash out, paid time off, career advancement opportunities, and resources to support employee and family wellbeing.

Equal Opportunity Employer/Disabled/Veterans

According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps” job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.

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Refine Your Search

prior authorization specialist work from home jobs in remote

Prior Authorization Specialist I

Insurance Authorization Specialist II

Prior Authorization Specialist - Required EPIC

Authorization Specialist - Revenue Cycle Management

Revenue Cycle Authorization Specialist

Referral Authorization Specialist

Prior Authorization Specialist

Authorization Specialist

ROI Medical Records Specialist - Remote

Insurance Verification & Authorization Specialist – Remote

Intake Specialist - Revenue Cycle Management

Surgical Authorization Specialist- Remote

Remote LTC Pharmacy Billing Specialist (FrameworkLTC experience)

Sr. Reimbursement Specialist

Insurance Verification Specialist - 3147/Remote - Full Time

PRN Insurance Specialist

PAHub & Prior Authorization Specialist

Acute Clearance Specialist - Intake Coordinator - Remote

Senior Claims Auditor - DRG

Insurance Eligibility & Follow-Up Specialist (Remote)

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