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Contract Insurance Prior Authorization Jobs (NOW HIRING)

MTK HealthCare

Prior Authorization Specialist

Hopedale, IL · On-site

$17 - $21.50/hr

... for a contract opportunity with Hopedale Medical Complex in Illinois. The ideal candidate will be responsible for insurance verification, obtaining prior authorizations, supporting financial ...

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Contract Insurance Prior Authorization information

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$25.5K

$65.7K

$83.5K

How much do contract insurance prior authorization jobs pay per year?

As of Jul 12, 2026, the average yearly pay for contract insurance prior authorization in the United States is $65,651.00, according to ZipRecruiter salary data. Most workers in this role earn between $61,000.00 and $77,000.00 per year, depending on experience, location, and employer.

What is the difference between Contract Insurance Prior Authorization vs Medical Insurance Claims Specialist?

AspectContract Insurance Prior AuthorizationMedical Insurance Claims Specialist
Primary RoleSecuring approval for specific procedures or treatments before serviceProcessing and managing insurance claims after services are rendered
Work EnvironmentHealthcare providers, insurance companies, or third-party administratorsHospitals, clinics, insurance companies, or claims processing centers
Required CredentialsKnowledge of insurance policies, healthcare regulations, often certifications in healthcare administrationUnderstanding of insurance billing, coding, and claims processing, often with certifications like CPC or CCS

Contract Insurance Prior Authorization involves obtaining approval before healthcare services, while Medical Insurance Claims Specialists handle post-service claims processing. Both roles require knowledge of insurance policies and healthcare regulations, but they focus on different stages of the insurance process.

More about Contract Insurance Prior Authorization jobs
What cities are hiring for Contract Insurance Prior Authorization jobs? Cities with the most Contract Insurance Prior Authorization job openings:
What are the most commonly searched types of Insurance Prior Authorization jobs? The most popular types of Insurance Prior Authorization jobs are:
What states have the most Contract Insurance Prior Authorization jobs? States with the most job openings for Contract Insurance Prior Authorization jobs include:
What job categories do people searching Contract Insurance Prior Authorization jobs look for? The top searched job categories for Contract Insurance Prior Authorization jobs are:
Contract Insurance Prior Authorization jobs near you
Infographic showing various Contract Insurance Prior Authorization job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 88% Full Time, 10% Part Time, and 1% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $65,651 per year, or $31.6 per hour.
Insurance Prior Authorizations Specialist

Insurance Prior Authorizations Specialist

Sound Retina PS

Tacoma, WA • On-site

$23 - $32.94/hr

Full-time

Posted 14 days ago

Job description

Description:

Job Description

Job Title: Prior Authorizations Specialist

Reports To: Financial Services Manager

FLSA Status: Non-Exempt

Job Summary: The Prior Authorizations Specialist is responsible for obtaining and managing insurance prior authorizations to ensure timely patient access to medically necessary retina services. This role works closely with providers, clinical staff, patients, and insurance carriers to verify coverage, secure authorizations, and maintain accurate documentation while ensuring compliance with payer requirements and regulatory guidelines. The ideal candidate is detail-oriented, proactive, and solutions-focused, with strong organizational skills and the ability to prioritize multiple requests in a fast-paced healthcare environment. Success in this role requires excellent communication, a commitment to quality and productivity, and the ability to work collaboratively to support exceptional patient care and positive financial outcomes for the practice.

Major Responsibilities

Position: Insurance Prior Authorizations Specialist

Department: Financial Services

Reports to: Financial Services Manager

Job Type: Full-Time, On-Site. Non-Exempt, Monday - Friday.

Responsibilities:

  • Review and monitor patient schedules in a timely manner as assigned by department lead, identifying patient procedures/treatments that require prior authorization.
  • Enters, verifies and updates demographic, insurance and pre-authorization information to ensure proper claims adjudication.
  • Answer patient and clinical staff questions regarding insurance coverage and pre-authorizations.
  • Follows all internal processes and procedures; follows all regulations and guidelines set by Medicare, state programs and PPO/HMO plans.
  • Determine when documentation does not meet medical policy guidelines and coordinate appropriate follow up by clinical staff members that aid in the prior authorization process.
  • Prioritizes incoming authorization requests according to urgency and necessity.
  • Understands prior authorization(s) that are necessary for any services that are rendered to patients at Sound Retina.
  • Initiates the steps necessary to obtain prior authorizations from insurance companies and performs appropriate follow up to meet all deadlines and prevent prior authorization denials.
  • Clearly document in practice management system all communications and contacts with payers, providers and personnel in standardized documentation requirements, including proper format.
  • Maintain detailed filing and archiving of prior authorizations to support post-claim denial workflows.
  • Stays informed, updated and researches information regarding insurance criteria for prior authorizations.
  • Update and maintain prior authorization tools.
  • Growing knowledge of HCPCs, CPT procedure codes and ICD-10 diagnosis updates.
  • Maintain daily productivity goals in completing a set number of accounts while also meeting quality standards as determined by leadership.
  • Ability to maintain patient confidentiality and present themselves in a professional manner.
  • Ensures compliance with State and Federal Laws & Regulations for Managed Care and other Third-Party Payors.
  • Provides general assistance when needed to patients, vendors, co-workers, etc.
  • Performs other duties as directed by the Billing Department Lead.

QUALIFICATIONS

  • High School Graduate or GED equivalent required.
  • 1+ year experience in insurance authorizations and coordination; ophthalmology and retina preferred.
  • 2-3 years previous experience in pre-auth verification; experience with obtaining authorizations, referral coordination and patient services.
  • 2-3 years previous experience with insurance eligibility.
  • Prior experience working Medicare, Medicaid, other government payers and commercial insurance.
  • Effective written and verbal communication skills.
  • Ability to multi-task, prioritize needs to meet required timelines.
  • Customer service experience required.
  • Able to demonstrate independent judgment and initiative appropriately

Job Type: Full-time

Requirements: