Remote Prior Authorization Nurse Job Description

Make an Impact from Anywhere

Are you ready to take charge of your future while helping others navigate the healthcare system more efficiently? As a Remote Prior Authorization Nurse, you'll be at the forefront of healthcare access, ensuring timely care delivery by facilitating prior authorizations across a wide range of medical services. This fully remote position empowers you to positively impact patient outcomes from the comfort of your own home while joining a mission-driven team dedicated to enhancing healthcare navigation nationwide.

This is more than a job—it's an opportunity to streamline lives and help patients move through treatment pathways with fewer delays and more confidence. Join a fast-growing team that thrives on innovation, efficiency, and compassionate care.

Annual Salary: $85,741

About the Role

Our Prior Authorization Nurses are trusted clinical experts who combine clinical insight with process precision to advocate for patients and healthcare providers. You'll review complex clinical information, interpret insurance policies, and communicate efficiently with both care teams and payers. This role is ideal for experienced RNs who are skilled communicators, strategic thinkers, and passionate about enhancing the patient experience.

Key Responsibilities

• Review and interpret clinical documentation to support prior authorization submissions for medical services, procedures, and equipment.
• Communicate effectively with physicians, specialists, and other healthcare providers to collect additional information as needed.
• Submit comprehensive prior authorization requests to insurance carriers, ensuring alignment with policy guidelines and medical necessity.
• Monitor status updates, denials, and approvals, escalating urgent or time-sensitive issues.
• Document authorization activity accurately in the electronic health record (EHR) and payer portals.
• Collaborate closely with utilization review and care coordination teams to ensure seamless care transitions.
• Maintain compliance with HIPAA, payer-specific protocols, and internal clinical review policies.
• Act as a patient advocate, ensuring that no administrative delays prevent necessary care delivery.

Your Work Environment

Enjoy the flexibility and autonomy of working remotely while being deeply connected to a collaborative and goal-oriented healthcare team. Our culture is rooted in support, innovation, and mutual respect.

• Fully remote work structure
• Flexible scheduling options to accommodate work-life balance
• Daily stand-ups and virtual team huddles to stay connected
• Transparent feedback culture and performance coaching
• Opportunities for cross-functional projects and leadership development

Tools and Technology You'll Use

Our platform makes your work seamless, integrating innovative technology with clinical workflows:

• Secure EMR systems for real-time documentation
• Payer-specific web portals for streamlined submissions
• AI-assisted documentation tools for reducing administrative burden
• HIPAA-compliant communication tools (e.g., Zoom, Slack, Microsoft Teams)
• Authorization tracking dashboards to keep tabs on timelines

Qualifications That Set You Apart

You're more than your license. We're looking for compassionate professionals who bring both experience and vision to our team.

• Active, unrestricted RN license (multi-state or compact license preferred)
• Minimum 2 years of clinical nursing experience
• Prior experience in medical management, case review, or utilization review is highly desired.
• Familiarity with insurance authorization processes across major payers
• Strong written and verbal communication skills
• An analytical mindset with attention to policy criteria and documentation accuracy
• Proficiency in navigating multiple digital tools and clinical systems
• Self-starter with excellent time management and organizational skills

What You'll Gain

Working with us isn't just about a paycheck. It’s about joining a supportive ecosystem that champions your growth:

• Competitive annual salary of $85,741
• Comprehensive health benefits package (medical, dental, vision)
• Paid time off, holidays, and wellness days
• 401(k) with company match
• Continuing education and certification reimbursement
• Dedicated mentorship programs and leadership tracks
• Employee recognition programs and remote team events

Why This Role Matters

Prior authorization is often the gatekeeper between a diagnosis and the treatment that could change a life. In this position, you make sure patients don’t fall through the cracks. You ensure timely access to life-saving therapies and simplify an otherwise frustrating process.

When you help a cancer patient get approval for their chemotherapy in record time, or ensure a child receives the medical equipment they need without weeks of delay, you become part of something much larger than just paperwork. You become part of their healing journey.

Growth Opportunities

We believe in investing in our people. As a Prior Authorization Nurse, you’ll gain exposure to diverse patient populations, payer systems, and healthcare policies—opening doors to advanced roles in utilization management, nurse consulting, and clinical operations.

Take ownership of process improvement initiatives, join internal task forces, or mentor new team members. The future is as wide as your ambition.

Your Next Big Opportunity Awaits

Ready to be the advocate that patients don’t even know they need? Prepared to turn complex policies into smooth patient journeys? Apply now to become a Remote Prior Authorization Nurse and step into a role where your clinical judgment truly matters.

Make a real difference. Work from anywhere. Grow without limits.

Take the next step in your career—we're excited to meet you!