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Contract Insurance Prior Authorization Jobs (NOW HIRING)

US Tech Solutions

$17 - $19/hr

$17-$19 per hour Remote, RI Contract Location: Fully remote Duration: 12 months contract * Prior Authorization Specialist takes in-bound calls from providers, pharmacies, members, etc providing ...

MC-Rx

Prior Authorization Coordinator

Miramar, FL

$21 - $23/hr

Manage the full lifecycle of prior authorization (PA) requests in support of manufacturer-sponsored ... Ensure adherence to all regulatory and privacy requirements, including the Health Insurance ...

Lumera Healthcare

Prior Authorization Associate

Paducah, KY

$18.25 - $22.50/hr

Insurance Authorization Coordinator Ensures that necessary approvals are obtained from insurance ... Submit complete, timely, and accurate prior authorization requests to insurance companies and ...

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

As of May 31, 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 May 2026, with employment types broken down into 3% As Needed, 40% Full Time, 51% Part Time, 2% Temporary, 2% Contract, and 2% Nights. Highlights an 96% Physical, and 4% Remote job distribution, with an average salary of $65,651 per year, or $31.6 per hour.
Prior Authorization Coordinator

Prior Authorization Coordinator

US Tech Solutions

Remote

$17 - $19/hr

Contractor

Posted 6 days ago

Job description

$17-$19 per hour

Remote, RI

Contract

Location: Fully remote

Duration: 12 months contract

Job Description:

  • Prior Authorization Specialist takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers through the criteria based prior authorization process.
  • Maintains complete, timely and accurate documentation of reviews.
  • Transfers all clinical questions, escalations and judgement calls to the pharmacist team.
  • The Rep I, Clinical Services will also assist with other duties as needed to include but not limited to: outbound calls, reviewing and processing Prior Auth's received via fax and ePA, monitoring and responding to inquiries via department mailboxes and other duties as assigned by the leadership team.
  • Work closely with providers to process prior authorization (PA) and drug benefit exception requests for multiple clients or lines of business and in accordance with Medicare Part D CMS Regulations.
  • Must apply information provided through multiple channels to the plan criteria defined through work instruction.
  • Research and conduct outreach via phone to requesting providers to obtain additional information to process coverage requests and complete all necessary actions to close cases.
  • Responsible for research and correction of any issues found in the overall process.
  • Phone assistance is required to initiate and/or resolve coverage requests.
  • Escalate issues to Coverage Determinations and Appeals Learning Advocates and management team as needed.
  • Must maintain compliance at all times with CMS and department standards.
  • Position requires schedule flexibility and additional cross training to learn all lines of business.
  • Flexibility for movement to different parts of the business to support volume where needed.

Responsibilities:

  • Utilizing multiple software systems to complete Medicare appeals case reviews
  • Meeting or exceeding government mandated timelines
  • Complying with turnaround time, productivity and quality standards
  • Conveying resolution to beneficiary or provider via direct communication and professional correspondence
  • Acquiring and maintaining basic knowledge of relevant and changing Med D guidance
  • Effectively manage work volume by handling inbound calls/fax/ePA requests utilizing appropriate courteous and professional behavior based upon established standards.
  • Comply with departmental, company, state, and federal requirements when processing all information to ensure accuracy of information being provided to internal and external customers.
  • Communication with other internal groups regarding determination status and results (seniors, pharmacists, appeals, etc).
  • Identify and elevate clinical inquiries to the pharmacist team as appropriate.

Experience:

  • 0-3 years in a customer service or call center environment managing 75 calls/day.
  • Six months of PBM/pharmaceutical related work strongly desired
  • At least two years of general business experience that includes problem resolution, business writing, quality improvement and customer service

Skills:

  • Prior Authorization
  • Medicare and Medicaid
  • Call handling experience.

Education:

  • High School diploma or GED

About US Tech Solutions:

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com (http://www.ustechsolutionsinc.com) .

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

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About US Tech Solutions

Sourced by ZipRecruiter

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.

Industry

It services

Company size

1,001 - 5,000 Employees

Headquarters location

Jersey City, NJ, US

Year founded

2000

Social media

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