Remote Health Insurance Authorization Specialist

Naukri Mitra; United States; Remote; USD 50,000 - 61,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid time off

Remote work stipend

Certification support

Wellness programs

Job summary

Naukri Mitra is seeking a Remote Health Insurance Authorization Specialist to manage the prior authorization process from start to finish. You will secure approvals for procedures, services, and medications by working with payers and providers.

The role emphasizes accuracy, speed, and effective communication in a fully remote setting. The position offers a $55,459 annual salary with benefits including health, dental, and vision insurance, PTO, a remote work stipend, and support for CMRS/CPB

Qualifications

• Attention to detail and accuracy in clinical documentation
• Strong written and verbal communication, especially for explaining denials to providers
• Ability to read and interpret clinical documentation accurately
• Proven track record handling high-volume prior authorizations
• Experience with EHRs, payer portals, and authorization workflows

Responsibilities

• Submit and track prior authorization requests for procedures, services, and medications
• Review clinical documentation to ensure payer medical necessity
• Follow up on pending requests and resolve delays
• Assist providers to appeal or resolve denials
• Maintain accurate authorization records in internal systems
• Coordinate with billing and case management on shared cases

Skills

Attention to detail

Verbal communication

Written communication

Reading clinical documentation

High-volume workload management

Education

Associate degree

Tools

EHR systems

Authorization software

Payer portals

Job description

Somewhere between a patient waiting on a procedure and an insurance company sitting on a decision, there's a person making calls, chasing paperwork, and pushing things forward. That's this job. The Role We're hiring a Remote Health Insurance Authorization Specialist to manage the prior authorization process from start to finish — securing approvals for procedures, services, and medications by working directly with insurance payers and healthcare providers. You'll spend your days reviewing clinical documentation, tracking authorization statuses, and stepping in when a request stalls or gets denied. It's detail work with real consequences: a delayed authorization can mean a delayed treatment. This is a fully remote position paying $55,459 annually.

A Day in This Role

• Submit and track prior authorization requests for medical procedures, services, and medications
• Review clinical documentation to confirm it meets payer-specific medical necessity guidelines
• Follow up on pending requests and resolve delays before they affect patient care
• Work with providers and office staff to appeal or resolve insurance denials
• Keep authorization records accurate and current in internal systems
• Coordinate with billing and case management teams on shared cases

What Gets You Hired

• Associate degree, at minimum
• At least 2 years of experience in medical insurance authorization, medical billing, or healthcare claims processing
• Solid understanding of prior authorization workflows and payer-specific policies
• Ability to read and interpret clinical documentation accurately
• Comfort managing a high volume of requests without letting quality slip
• Working knowledge of EHR systems, authorization software, and payer portals
• Clear written and verbal communication, especially when explaining denials or delays to providers
• Nice-to-Haves
• Direct experience with Epic, Cerner, or Athenahealth
• Certified Medical Reimbursement Specialist (CMRS) or Certified Professional Biller (CPB) credential
• Background in medical coding or payer contract review
• Prior exposure to healthcare compliance work

Tools

• Day-to-day, you'll work inside EHR platforms, insurance eligibility and verification tools, and payer portals, with Microsoft Teams or Slack for internal communication.
• Everything runs through HIPAA-compliant systems, and you'll need to move between them without losing track of where each case stands.

What Makes This Role Different From General Billing Work

Authorization work sits closer to the patient than most back-office healthcare roles. You're not just processing a claim after the fact — you're often the reason a procedure happens on time or gets pushed back a month. Teams that hire well for this position, including several that post through Naukri Mitra, tend to look specifically for people who can hold both the administrative precision and the persistence needed to push a stuck case through.

Pay and Benefits

• Along with the $55,459 base salary, this role includes:
• Health, dental, and vision insurance
• Paid time off and company holidays
• A remote work stipend to cover your home office setup
• Support for professional certifications, including CMRS and CPB
• Access to mental health and wellness programs

Where This Can Lead

Most people don't stay in pure authorization work forever — it's often a stepping stone into broader healthcare administration. Over time, you'll build knowledge that transfers into medical coding, compliance, payer contract management, or team lead roles. If you're interested in mentoring newer specialists or taking on cross-functional projects, those opportunities tend to open up once you've got a year or two of solid case history behind you.

How We Work

The schedule is structured but not rigid — you're measured on outcomes, not on being visibly online every minute. Regular check-ins keep the team connected, and training sessions run often enough that you're never expected to figure out a tricky payer policy entirely on your own.

Open to remote applicants in eligible regions, including the USA and India. Location eligibility is confirmed as part of the hiring process. Candidates must have an Associate degree and at least two years of experience in medical insurance authorization, medical billing, or healthcare claims processing. They should understand prior authorization workflows, interpret clinical documentation accurately, manage high-volume workloads, and communicate effectively with providers and insurance payers.