Is the *New - Prior Authorization Specialist (Experience)- Remote position at NYX Health, LLC fully remote?

Yes, this *New - Prior Authorization Specialist (Experience)- Remote position at NYX Health, LLC is a remote position. The role is available for candidates in United States.

*New - Prior Authorization Specialist (Experience)- Remote at NYX Health, LLC

United States

$0.021k - $0.023k

Prior Authorization Specialist – Remote Position Summary We’re looking for a driven, detail‑oriented individual to join our team as a Prior Authorization Specialist. You’ll receive training and ongoing support to set you up for success. As part of this role, you’ll complete accurate insurance verifications and prior authorizations to ensure timely reimbursement. You’ll also collaborate with clinicians and insurance payors in a fast‑paced environment to manage claims, documentation, and approvals. If you enjoy problem‑solving, staying organized, and making a meaningful impact—both independently and as part of a team—we’d love to hear from you. Key Responsibilities <ul style="margin-top: 0in; margin-bottom: 0in;" type="disc"> <li style="margin-right: 9.35pt; margin-bottom: 0in; line-height: 115%; margin-top: 0in; font-size: 12pt; font-family: Aptos, sans-serif;">Pharmacy Benefits PA Submissions</li> <li style="margin-right: 9.35pt; margin-bottom: 0in; line-height: 115%; margin-top: 0in; font-size: 12pt; font-family: Aptos, sans-serif;"> Navigating EMR/PM systems for demographic information, patient clinical notes, and labs.</li> <li style="margin-right: 9.35pt; margin-bottom: 0in; line-height: 115%; margin-top: 0in; font-size: 12pt; font-family: Aptos, sans-serif;">Coordinate initial submission of prior authorization processes including preparation of PA, answering Prior Authorization clinical questions, submitting Pharmacy benefit PA's</li> <li style="margin-right: 9.35pt; margin-bottom: 0in; line-height: 115%; margin-top: 0in; font-size: 12pt; font-family: Aptos, sans-serif;">Utilize covermymeds to complete submission of Prior Authorizations</li> <li style="margin-right: 9.35pt; margin-bottom: 0in; line-height: 115%; margin-top: 0in; font-size: 12pt; font-family: Aptos, sans-serif;">Communicate with providers and insurance companies regarding authorization status.</li> <li style="margin-right: 9.35pt; margin-bottom: 0in; line-height: 115%; margin-top: 0in; font-size: 12pt; font-family: Aptos, sans-serif;">Maintain HIPAA compliance and support daily revenue cycle operations.</li> <li style="margin-right: 9.35pt; margin-bottom: 0in; line-height: 115%; margin-top: 0in; font-size: 12pt; font-family: Aptos, sans-serif;"> Aprima experience+</li> </ul>   Skills & Qualifications  <ul style="margin-top: 0in; margin-bottom: 0in;" type="disc"> <li style="margin-right: 9.35pt; margin-bottom: 0in; line-height: 115%; margin-top: 0in; font-size: 12pt; font-family: Aptos, sans-serif;">3-5 years rheumatology medication PA experience is Required</li> <li style="margin-right: 9.35pt; margin-bottom: 0in; line-height: 115%; margin-top: 0in; font-size: 12pt; font-family: Aptos, sans-serif;">Specialty Pharmacy experience - Required</li> <li style="margin-right: 9.35pt; margin-bottom: 0in; line-height: 115%; margin-top: 0in; font-size: 12pt; font-family: Aptos, sans-serif;">5+ years of prior authorization experience -Required</li> <li style="margin-right: 9.35pt; margin-bottom: 0in; line-height: 115%; margin-top: 0in; font-size: 12pt; font-family: Aptos, sans-serif;">Knowledge of rheumatology medications and biosimilars -Required</li> <li style="margin-right: 9.35pt; margin-bottom: 0in; line-height: 115%; margin-top: 0in; font-size: 12pt; font-family: Aptos, sans-serif;">Proficient in EMR systems, Covermymeds, ECW, NextGen Emrs</li> <li style="margin-right: 9.35pt; margin-bottom: 0in; line-height: 115%; margin-top: 0in; font-size: 12pt; font-family: Aptos, sans-serif;">Strong communication, problem-solving, and organizational skills.</li> <li style="margin-right: 9.35pt; margin-bottom: 0in; line-height: 115%; margin-top: 0in; font-size: 12pt; font-family: Aptos, sans-serif;">Detail-oriented, analytical, and able to multitask in a fast-paced environment.</li> </ul>   Education & Experience <ul style="margin-top: 0in; margin-bottom: 0in;" type="disc"> <li style="margin-right: 9pt; margin-bottom: 0in; line-height: 115%; margin-top: 0in; font-size: 12pt; font-family: Aptos, sans-serif;">High School Diploma required; additional education in business or healthcare preferred.</li> <li style="margin-right: 9pt; margin-bottom: 0in; line-height: 115%; margin-top: 0in; font-size: 12pt; font-family: Aptos, sans-serif;">Experience in  prior authorization,  utilization  review,  insurance verification,  and  EMR systems. [preferred]</li> </ul> Work Environment & Physical Requirements <ul style="margin-top: 0in; margin-bottom: 0in;" type="disc"> <li style="margin-right: 9pt; margin-bottom: 0in; line-height: 115%; margin-top: 0in; font-size: 12pt; font-family: Aptos, sans-serif;">Remote position</li> <li style="margin-right: 9pt; margin-bottom: 0in; line-height: 115%; margin-top: 0in; font-size: 12pt; font-family: Aptos, sans-serif;">Prolonged computer use; ability to lift up to 15 lbs.</li> </ul> Job Type, Schedule & Compensation <ul style="margin-top: 0in; margin-bottom: 0in;" type="disc"> <li style="margin-right: 9pt; margin-bottom: 0in; line-height: 115%; margin-top: 0in; font-size: 12pt; font-family: Aptos, sans-serif;">Full-time, Monday–Friday, 8-hour day shift.</li> <li style="margin-right: 9pt; margin-bottom: 0in; line-height: 115%; margin-top: 0in; font-size: 12pt; font-family: Aptos, sans-serif;">Pay: $21–$23 per hour, [With additional pay available for exceptional experience.]</li> </ul>

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Remote Opportunity

*New - Prior Authorization Specialist (Experience)- Remote

Join NYX Health, LLC as a senior professional working remotely from United States. Explore the role, benefits, and apply in one place.

*New - Prior Authorization Specialist (Experience)- Remote

NYX Health, LLC

Full Time

$0.021k - $0.023k

4 weeks ago

Prior Authorization Specialist – Remote Position Summary We’re looking for a driven, detail‑oriented individual to join our team as a Prior Authorization Specialist. You’ll receive training and ongoing support to set you up for success.

United States

Engineering

Senior

Prior Authorization

Specialty pharmacy

Insurance Verification

+5 more

Job Description

Prior Authorization Specialist – Remote

Position Summary
We’re looking for a driven, detail‑oriented individual to join our team as a Prior Authorization Specialist. You’ll receive training and ongoing support to set you up for success. As part of this role, you’ll complete accurate insurance verifications and prior authorizations to ensure timely reimbursement. You’ll also collaborate with clinicians and insurance payors in a fast‑paced environment to manage claims, documentation, and approvals. If you enjoy problem‑solving, staying organized, and making a meaningful impact—both independently and as part of a team—we’d love to hear from you.

Key Responsibilities

Pharmacy Benefits PA Submissions
Navigating EMR/PM systems for demographic information, patient clinical notes, and labs.
Coordinate initial submission of prior authorization processes including preparation of PA, answering Prior Authorization clinical questions, submitting Pharmacy benefit PA's
Utilize covermymeds to complete submission of Prior Authorizations
Communicate with providers and insurance companies regarding authorization status.
Maintain HIPAA compliance and support daily revenue cycle operations.
Aprima experience+

Skills & Qualifications

3-5 years rheumatology medication PA experience is Required
Specialty Pharmacy experience - Required
5+ years of prior authorization experience -Required
Knowledge of rheumatology medications and biosimilars -Required
Proficient in EMR systems, Covermymeds, ECW, NextGen Emrs
Strong communication, problem-solving, and organizational skills.
Detail-oriented, analytical, and able to multitask in a fast-paced environment.

Education & Experience

High School Diploma required; additional education in business or healthcare preferred.
Experience in prior authorization, utilization review, insurance verification, and EMR systems. [preferred]

Work Environment & Physical Requirements

Remote position
Prolonged computer use; ability to lift up to 15 lbs.

Job Type, Schedule & Compensation

Full-time, Monday–Friday, 8-hour day shift.
Pay: $21–$23 per hour, [With additional pay available for exceptional experience.]

Skills

Prior Authorization

Specialty pharmacy

Insurance Verification

EMR Systems

CoverMyMeds

NextGen

Rheumatology Medication

ECW

Ready to Apply?

Join NYX Health, LLC today

Salary Range

$0.021k - $0.023k

Posted 4 weeks ago

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