Top 230 Remote prior authorization 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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Prior Authorization Specialist-Vascular
Mountain Spring Vascular LLC —Warrenton, VA
- Full-time
- Remote
- Computer literacy
- HIPAA
- Mid-level
- Health insurance
- Dental insurance
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AI Training Generalist (No Prior Experience Needed) - Freelance AI Trainer Project
Meridial —Virginia Beach, VA
- $20 an hour
- Remote
- No experience needed
- US work authorization
- Entry level
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
Quick Apply
Reimbursement Specialist Supervisor - Remote
VCU Health System —Richmond, VA
- Full-time
- Remote
- Mid-level
- 3 years
- High school diploma or GED
Pre-Visit Specialist I - Hospital Call Center (Scheduling & Pre-Registration)
Augusta Health —Fishersville, VA
- $17.72 - $24.46 an hour
- Full-time
- Hybrid work
- Psychiatry
- No experience needed
- High school diploma or GED
- Free parking
- Health insurance
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Insurance Specialist - Home Care
Care Advantage Inc. Corporate —Richmond, VA
- Full-time
- Hybrid work
- Mid-level
- Administrative experience
- High school diploma or GED
- Disability insurance
- Health insurance
Quick Apply
9d
Contracts & CPSR Compliance Consultant (Remote)
BOOST LLC —Reston, VA
- $110,000 - $130,000 a year
- Remote
- 3 years
- Analysis skills
- US work authorization
- Health insurance
- Dental insurance
Quick Apply
Intake Specialist (In-Office if Local / Remote if Non-Local)
UNITED WOUND HEALING PS —Roanoke, VA
- $19 - $23 an hour
- Overtime
- Microsoft Outlook
- Pass drug screening
- HIPAA
- AD&D insurance
- Paid holidays
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Cardiac Device Monitoring Coordinator
VHC Health —Arlington, VA
- Full-time
- Medical office experience
- Mid-level
- Administrative experience
- Health insurance
- Dental insurance
13d
Housing Compliance Analyst
Volunteers of America, Inc. —Alexandria, VA
- $45,000 - $60,000 a year
- Mid-level
- High school diploma or GED
- Data entry
- Wellness program
- Paid holidays
Quick Apply
13d
Applications Analyst, Senior - Willow, Willow Ambulatory, Specialty Pharmacy - Remote
VCU Health System —Richmond, VA
- Full-time
- Remote
- Computer Science
- Research
- 3 years
Radar Operator-3
Raytheon —Chesapeake, VA
- $28.91 an hour
- Full-time
- Windows
- High school diploma or GED
- Trade school
- Paid holidays
- Disability insurance
Weight Management Certified Medical Assistant
Aspire Weight Loss Solutions, LLC —Richmond, VA
- $20 an hour
- Part-time
- Remote
- Primary Care
- HIPAA
- English
- Employee discount
- Flexible schedule
Quick Apply
2d
Credit Specialist
Airbus Americas, Inc. —Herndon, VA
- $59,000 - $69,900 a year
- Online Application
- Spanish
- ERP systems
- English
- Profit sharing
- Paid parental leave
8d
Operation Trade Specialist
Moog Inc. —Blacksburg, VA
- $80,000 - $105,000 a year
- Full-time
- Remote
- 5 years
- Bachelor's degree
- Travel
- Health savings account
- Employee stock purchase plan
1d
Defensive Cyber Operations (DCO) Analyst
Dark Wolf Solutions —Herndon, VA
- $100,000 - $145,000 a year
- Full-time
- Hybrid work
- Computer Science
- Research
- Mid-level
Medical Billing Specialist (ON SITE in Virginia Beach)
Thrive Proactive Health —Virginia Beach, VA
- Part-time
- HIPAA
- Mid-level
- Clinic
Quick Apply
13d
Information Assurance Manager
Virginia Tech —Blacksburg, VA
- From $130,000 a year
- Weekends as needed
- Computer Science
- Customer service
- Windows
Regional Evidence Custodian
Virginia Alcoholic Beverage Control Authority —Mechanicsville, VA
- $24 an hour
- Part-time
- Writing skills
- Mid-level
- Office

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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.

Quick Apply

Refine Your Search

remote prior authorization jobs in virginia

Pharmacy Prior Authorization Coordinator I

Prior Authorization Specialist-Vascular

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

Patient Contact Center Representative (Remote)

Reimbursement Specialist Supervisor - Remote

Pre-Visit Specialist I - Hospital Call Center (Scheduling & Pre-Registration)

Insurance Specialist - Home Care

Contracts & CPSR Compliance Consultant (Remote)

Intake Specialist (In-Office if Local / Remote if Non-Local)

Cardiac Device Monitoring Coordinator

Housing Compliance Analyst

Applications Analyst, Senior - Willow, Willow Ambulatory, Specialty Pharmacy - Remote

Radar Operator-3

Weight Management Certified Medical Assistant

Credit Specialist

Operation Trade Specialist

Defensive Cyber Operations (DCO) Analyst

Medical Billing Specialist (ON SITE in Virginia Beach)

Information Assurance Manager

Regional Evidence Custodian

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

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