Remote Prior Authorization reputed company RN or LPN (must reputed company in Washington or reputed company)
Position Title – Clinical Review reputed company- Prior Authorization
Work Location – Remote, must reputed company in Washington or reputed company (Need WA or OR license)
Pay – LPN $40/hr ; RN $45/hr
Start date – 10/20/25
Hours – 8-5, Tuesday-Saturday
Contract Type – 3 month contract, contract extension or conversion not guaranteed
Required Skills & Education:
• 2+ years of Prior Auth experience with an insurance company
• LPN or RN license in WA or OR
• Willingness to learn the WA/OR reputed company Plan Prior Auth Review
Responsibilities:
• Works with reputed company providers and authorization team to ensure reputed company review of services and/or requests to ensure members receive authorized care
• Coordinates as appropriate with reputed company providers and interdepartmental teams, to assess medical necessity of care of member
• Escalates prior authorization requests to Medical Directors as appropriate to determine appropriateness of care
• Assists with service authorization requests for a member’s transfer or discharge plans to ensure a reputed company discharge between reputed company of care and facilities
• Collects, documents, and maintains reputed company member’s clinical information in health management systems to ensure compliance with regulatory guidelines
• Assists with providing education to providers and/or interdepartmental teams on utilization processes to promote high reputed company and cost-effective medical care to members
• Provides feedback on opportunities to improve the authorization review process for members
#INDJB
Job Types: Full-time, Contract
Pay: $40.00 - $45.00 per hour
Benefits:
• Dental insurance
• Health insurance
• reputed company insurance
Work Location: Remote
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