Top 437 Remote medical Jobs in Virginia

Pharmacy Prior Authorization Coordinator I
Sentara Health Administration, Inc. —Virginia Beach, VA
- $19.04 - $31.73 an hour
- Overtime
- Remote
- High school diploma or GED
- 1 year
- Entry level
- 403(b) matching
- Paid parental leave
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Outbound Call Center Rep
CVS Health —Virginia
- $15.00 - $26.93 an hour
- Full-time
- Remote
- Background check
- HIPAA
- High school diploma or GED
- Paid training
- Employee stock purchase plan
Customer Service Representative I
Sentara Hospitals —Virginia Beach, VA
- Full-time
- Remote
- High school diploma or GED
- Travel
- Epic
- 403(b) matching
- Paid parental leave
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Customer Service Representative
Sentara Hospitals —Virginia Beach, VA
- Full-time
- Remote
- Mid-level
- High school diploma or GED
- Travel
- 403(b) matching
- Paid parental leave
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Customer Service - Work at Home
ibex Limited —Hampton, VA
- Remote
- Entry level
- Paid training
- Health insurance
Patient Enrollment Representative (Remote)
Mosaic Pharmacy —Sterling, VA
- $18 - $20 an hour
- Full-time
- Remote
- Background check
- Spanish
- Pass drug screening
- Health savings account
- AD&D insurance
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Patient Contact Center Representative (Remote)
Mosaic Pharmacy —Sterling, VA
- $18 - $20 an hour
- Full-time
- Remote
- Background check
- Spanish
- Microsoft Outlook
- Health savings account
- AD&D insurance
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Call Center Remote Customer Service Representative
D&A CONSULTING SERVICE LLC —Virginia
- $17.00 - $18.50 an hour
- Full-time
- Remote
- Background check
- 18 years or older
- Spanish
- Paid training
- Paid time off
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Customer Service Rep – Healthcare (UMA Grads, Remote)
Concentrix —Virginia
- $15 - $17 an hour
- Urgently hiring
- Remote
- Computer literacy
- Residential
- High school diploma or GED
- Paid training
- Paid holidays
Care Coordinator for LTSS Waiver Members/Medicaid - Remote in NOVA (Fairfax, Springfield and Alexandria, VA)
Sentara Health Administration, Inc. —Fairfax, VA
- Full-time
- Remote
- Nursing
- Caregiving
- Travel
- 403(b) matching
- Paid parental leave
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3d
Medical Only Claims Specialist
CorVel Corporation —Glen Allen, VA
- $16.74 - $26.92 an hour
- Full-time
- Remote
- Customer service
- Computer literacy
- Mid-level
- Health savings account
- Disability insurance
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PEC OPH/Patient Engagement Center Advocate
Eye Care Partners Career Opportunities —Norfolk, VA
- $17 an hour
- Evenings as needed
- Remote
- Microsoft Outlook
- Computer literacy
- Writing skills
- Paid training
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9d
Pharmacy Onboarding Enrollment Coordinator
Mosaic Pharmacy —Sterling, VA
- $26 - $28 an hour
- Overtime
- Remote
- Background check
- Pass drug screening
- Mid-level
- Health savings account
- AD&D insurance
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Branch Coordinator - TELEWORK
Apria Healthcare LLC —Glen Allen, VA
- $16.66 - $20.97 an hour
- Full-time
- Remote
- Background check
- Inventory management
- Computer literacy
- Paid parental leave
- Disability insurance
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6d
Manager, Call Center Operations
Mosaic Pharmacy —Sterling, VA
- $90,000 - $100,000 a year
- Weekends as needed
- Remote
- Background check
- Pass drug screening
- Travel
- Health savings account
- AD&D insurance
Quick Apply
Patient Billing Representative
Five Star Call Centers —Woodbridge, VA
- $14 an hour
- Full-time
- Remote
- Background check
- HIPAA
- English
- Paid training
11d
Telephonic Case Manager
Sedgwick —Newport News, VA
- Full-time
- Remote
- Nursing
- RN License
- Mid-level
- Continuing education credits
- Health savings account
5d
Reimbursement Specialist Supervisor - Remote
VCU Health System —Richmond, VA
- Full-time
- Remote
- Mid-level
- 3 years
- High school diploma or GED
Senior Healthcare Data Analyst - Remote
Sentara Health —Virginia Beach, VA
- $80,204.80 - $133,681.60 a year
- Overtime
- Remote
- Mid-level
- 3 years
- Master's degree
- 403(b) matching
- Paid parental leave
Quick Apply
Home Health Intake Lead
Home Recovery Home Aid —Richmond, VA
- Full-time
- Remote
- Mid-level
- High school diploma or GED
- Supervising experience

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Pharmacy Prior Authorization Coordinator I

Sentara Health Administration, Inc.
Virginia Beach, VA

Quick Apply

Job Details

Full-time
$19.04 - $31.73 an hour

Benefits

403(b) matching
Paid parental leave
Caregiver leave
Disability insurance
Health insurance
Dental insurance
Tuition reimbursement
Paid time off
Parental leave
Vision insurance
401(k) matching
403(b)
Life insurance
Pet insurance

Qualifications

Decision making

Full Job Description

City/State

Virginia Beach, VA

Work Shift

First (Days)

Overview:

Sentara Health Plans is looking to hire Pharmacy Prior Authorization Coordinator 1:

This is a remote position: Remote opportunities available in the following states: Virginia, North Carolina, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington (state), West Virginia, Wisconsin, Wyoming

Shift: Monday- Friday from 8:00am to 8:00pm and must be flexible to work on weekends.

The Pharmacy Prior Authorization Coordinator I is responsible for delivering high-quality customer service by answering and managing calls from members, provider offices, and pharmacies. This role supports the processing of prior authorization (PA) requests for pharmacy benefit medications, ensuring accuracy, compliance with regulatory and clinical guidelines, and alignment with client performance standards. The Coordinator I works under general supervision, using established protocols and systems to support timely, efficient, and accurate PA determinations.

This role uses various business systems and tools to retrieve information, analyze requests, and enter prior authorization data required for claims adjudication. The Coordinator I applies reasoning skills to identify incomplete information and determine appropriate actions based on client-specific criteria and clinical protocols (e.g., approve, pend, refer for clinical decision). The position interacts regularly with internal teams and external stakeholders to ensure consistent, high-quality service delivery. Work is performed under general supervision, with reliance on documented procedures, training, and prior experience to guide day-to-day activities.

Key Responsibilities

Verify member insurance eligibility and pharmacy benefit coverage.

Communicate with members and providers regarding basic pharmacy inquiries and PA status.

Accurately enter and process prior authorization (PA) requests into the system, prioritizing appropriately.

Ensure PA requests are processed and finalized within required turnaround times (TAT) and client Performance Guarantees (PGs), using provided clinical guidelines.

Review medication history and assess for formulary alternatives and “tried and failed” drugs.

Document all relevant PA information clearly and accurately, including approval or denial rationale.

Send PA status updates to providers and pharmacies via fax or other required methods.

Adhere to defined roles and responsibilities related to clinical decision-making boundaries.

Meet or exceed productivity and accuracy targets for PA processing.

Coordinate with members, providers, and pharmacies to obtain missing information or clarification.

Make outbound calls to gather additional information or respond to inquiries related to PAs, clinical programs, or claim adjudication.

Collaborate with Pharmacy Concierge teams to resolve questions or issues related to PA processing or pharmacy benefits.

Maintain strict confidentiality and security of all member and PA-related data, following applicable protocols for data handling and storage.

In addition to the above responsibilities, other duties may be assigned.

Education

High School Diploma or GED strongly preferred.

Experience

1 year healthcare experience required.

We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is: $19.04/HR – $31.73/HR. Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities

Benefits: Caring For Your Family and Your Career

Medical, Dental, Vision plans
Adoption, Fertility and Surrogacy Reimbursement up to $10,000
Paid Time Off and Sick Leave
Paid Parental & Family Caregiver Leave
Emergency Backup Care
Long-Term, Short-Term Disability, and Critical Illness plans
Life Insurance
401k/403B with Employer Match
Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
Student Debt Pay Down – $10,000
Reimbursement for certifications and free access to complete CEUs and professional development
Pet Insurance
Legal Resources Plan
Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

In support of our mission “to improve health every day,” this is a tobacco-free environment.

For positions that are available as remote work, Sentara Health employs associates in the following states:

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

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Refine Your Search

remote medical jobs in virginia

Pharmacy Prior Authorization Coordinator I

Outbound Call Center Rep

Customer Service Representative I

Customer Service Representative

Customer Service - Work at Home

Patient Enrollment Representative (Remote)

Patient Contact Center Representative (Remote)

Call Center Remote Customer Service Representative

Customer Service Rep – Healthcare (UMA Grads, Remote)

Care Coordinator for LTSS Waiver Members/Medicaid - Remote in NOVA (Fairfax, Springfield and Alexandria, VA)

Medical Only Claims Specialist

PEC OPH/Patient Engagement Center Advocate

Pharmacy Onboarding Enrollment Coordinator

Branch Coordinator - TELEWORK

Manager, Call Center Operations

Patient Billing Representative

Telephonic Case Manager

Reimbursement Specialist Supervisor - Remote

Senior Healthcare Data Analyst - Remote

Home Health Intake Lead

I want to receive the latest job alert for remote medical in virginia

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