MA / LPN - Remote Prior Authorization

Salary: USD25 - USD28 per hour

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Prior Authorization Specialist (LPN /MA / Certified Medical Assistant)

Position Title: Prior Authorization Specialist

Pay Rate: $25.00 – $28.00 / hour (based on experience)

Position Type: 3 to 6-Month Contract (Potential for Extension)

Location: Remote (Candidate must reside in the Central Time Zone (CST) and within ~50 miles of Bloomington, MN for equipment pickup)

Schedule: Monday – Friday, 8:00 AM – 5:00 PM CST

Position Overview

We are seeking self‑motivated, technology‑savvy healthcare professionals to join our team as Prior Authorization Specialists . In this remote role, you will focus on supporting medication prior authorizations—including high‑volume specialty therapies like GLP‑1s—to ensure timely access to vital patient treatments.

Note: While day‑to‑day work is 100% remote, candidates must reside within ~50 miles ofBloomington, MN to pick up company‑provided equipment during the week of Labor Day.

Key Responsibilities

• Documentation & Submission: Gather clinical progress notes, laboratory results, and patient charts from EPIC; complete and submit prior authorization (PA) requests accurately via insurance portals.
• Coverage & Eligibility Verification: Investigate health plan requirements, determine which medications mandate prior authorization, check specific coverage policies, and verify patient eligibility.
• Tracking & Follow‑Up: Proactively monitor the status of submitted requests, managing timelines and responding promptly to requests for additional clinical information.
• Denials & Appeals Support: Initiate the appeals process for denied medication authorizations, partnering closely with prescribing physicians to gather necessary clinical justification.
• Multidisciplinary Coordination: Communicate effectively with prescribing providers, clinic staff, pharmacists, and patients to resolve coverage bottlenecks and expedite approvals.

Position Requirements

• Professional Credentials (Must possess AT LEAST ONE of the following):
• Active Certified Medical Assistant (CMA) credential through the AAMA.
• Active, unencumbered LPN License.
• Medical Assistant Diploma from an accredited program verified by CAAHEP or ABHES.
• Experience & Technical Skills:
• EPIC Proficiency: Minimum 1 year of hands‑on experience navigating and documenting within EPIC EHR.
• Prior Authorization Experience: Minimum 1 year of dedicated experience processing medication prior authorizations.
• Location & Equipment: Must reside in Central Standard Time (CST) within ~50 miles of the client site to pick up equipment in person the week of Labor Day. Must own a personal smartphone for dual‑factor authentication.
• Professional Attributes: Self‑motivated, tech‑savvy, detail‑oriented, and able to thrive in a fast‑paced environment.

Preferred Qualifications

• 2+ years of experience managing complex medication prior authorizations.
• Direct experience handling GLP‑1 prior authorization requests and appeals.
• Background working in high‑volume clinic or health system environments.

Why You’ll Love Working Here

• Work‑from‑Home Convenience: 100% remote day‑to‑day workflow following initial local equipment pickup.
• Consistent Schedule: Enjoy steady, predictable daytime hours with weekends off.
• Impactful Work: Help patients navigate complex insurance landscapes to obtain the critical medications they need.