Registered Nurse – Prior Authorization Specialist

Registered Nurse (RN) – Prior Authorization Specialist

Full-Time | Remote | EST Time Zone (US-based)
Salary: PHP 25,000/month

Job Description
We are seeking experienced Registered Nurses (RNs) to join our healthcare team as Prior Authorization Specialists. This role focuses on handling prior authorizations for our diagnostic and ancillary programs, ensuring timely approvals and accurate documentation while working remotely.

This position is ideal for RNs with strong prior authorization or utilization review experience who are familiar with U.S. healthcare workflows and eClinicalWorks.

Key Responsibilities

• Process and submit prior authorizations for:
• Diagnostic imaging
• Medications
• Stress tests
• Review clinical documentation to support medical necessity
• Communicate with insurance providers to secure approvals
• Follow up on pending, delayed, or denied authorizations
• Document autho...