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Full Time Optum Prior Authorization Jobs (NOW HIRING)

CareMed Specialty Pharmacy

$23 - $25/hr

Pharmacy Prior Authorization Specialist - CareMed Specialty Pharmacy Buffalo, NY | Full-Time | Starting at $23.00/hr and up Sign-On Bonus: $5,000 for employees starting before July 31, 2026. Join a ...

MC-Rx

Prior Authorization Coordinator

Miramar, FL

$21 - $23/hr

Manage the full lifecycle of prior authorization (PA) requests in support of manufacturer-sponsored ... This is a full-time position with benefits. Please visit our Contact Us/Opportunities page on our ...

MDxHealth

Prior Authorization Specialist

Irvine, CA · On-site

$19.26 - $23/hr

The Prior Authorization Specialist is responsible for all aspects of the prior authorization ... Position is full time. * Shift is Monday to Friday, 6:00am to 2:30pm (Pacific Time) * Applicant ...

MC-Rx

Prior Authorization Coordinator

Gainesville, GA · On-site

$21 - $23/hr

Manage the full lifecycle of prior authorization (PA) requests in support of manufacturer-sponsored ... This is a full-time position with benefits. Please visit our Contact Us/Opportunities page on our ...

MC-Rx

Prior Authorization Coordinator

Miramar, FL · On-site

$21 - $23/hr

Manage the full lifecycle of prior authorization (PA) requests in support of manufacturer-sponsored ... This is a full-time position with benefits. Please visit our Contact Us/Opportunities page on our ...

MC-Rx

Prior Authorization Coordinator

Gainesville, GA

$21 - $23/hr

Manage the full lifecycle of prior authorization (PA) requests in support of manufacturer-sponsored ... This is a full-time position with benefits. Please visit our Contact Us/Opportunities page on our ...

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All JobsFull Time Optum Prior Authorization Jobs

Full Time Optum Prior Authorization information

What are Full Time Optum Prior Authorization jobs?

Full Time Optum Prior Authorization jobs involve reviewing and processing requests from healthcare providers to determine if certain medical procedures, medications, or services are covered under a patient’s health insurance plan. Employees in these roles work for Optum, a healthcare services company, and typically assess clinical documentation, apply medical policy guidelines, and communicate decisions to providers or members. These positions are full-time and may require collaboration with other healthcare professionals to ensure that patients receive appropriate and necessary care while managing costs.

What are some common challenges faced by Full Time Optum Prior Authorization specialists, and how can they be managed?

Full Time Optum Prior Authorization specialists often encounter challenges such as navigating complex insurance requirements, managing high call volumes, and ensuring timely approvals for patient medications or procedures. Staying organized, maintaining up-to-date knowledge of changing payer guidelines, and leveraging internal support tools can help manage these challenges. Collaboration with providers, pharmacists, and insurance representatives is key to resolving issues efficiently and providing excellent patient service.

What is the difference between Full Time Optum Prior Authorization vs Medical Claims Processor?

AspectFull Time Optum Prior AuthorizationMedical Claims Processor
CredentialsTypically requires healthcare-related certifications or experienceUsually requires medical billing or coding certifications
Work EnvironmentOffice-based, healthcare insurance settingOffice-based, insurance or healthcare organization
Employer & IndustryOptum, healthcare insurance industryHealth insurance companies, healthcare providers
Primary FocusReviewing and approving prior authorization requestsProcessing and reviewing medical claims for payment

Full Time Optum Prior Authorization specialists focus on evaluating prior authorization requests to ensure coverage approval, while Medical Claims Processors handle the processing and adjudication of medical claims. Both roles require healthcare knowledge but differ in their specific responsibilities within the insurance process.

What are the key skills and qualifications needed to thrive as a Full Time Optum Prior Authorization Specialist, and why are they important?

To excel as a Full Time Optum Prior Authorization Specialist, you need a strong understanding of healthcare insurance processes, medical terminology, and prior authorization requirements, often supported by experience in healthcare administration. Familiarity with electronic health record (EHR) systems, claims processing software, and Optum's proprietary platforms is typically expected. Attention to detail, excellent communication, and problem-solving abilities are crucial soft skills for effectively coordinating between providers, patients, and insurance payers. These competencies ensure timely and accurate processing of authorizations, helping patients receive appropriate care while supporting organizational efficiency and regulatory compliance.
More about Full Time Optum Prior Authorization jobs
What cities are hiring for Full Time Optum Prior Authorization jobs? Cities with the most Full Time Optum Prior Authorization job openings:
What are the most commonly searched types of Optum Prior Authorization jobs? The most popular types of Optum Prior Authorization jobs are:
What states have the most Full Time Optum Prior Authorization jobs? States with the most job openings for Full Time Optum Prior Authorization jobs include:
What job categories do people searching Full Time Optum Prior Authorization jobs look for? The top searched job categories for Full Time Optum Prior Authorization jobs are:
Full Time Optum Prior Authorization jobs near you
Infographic showing various Full Time Optum Prior Authorization job openings in the United States as of June 2026, with employment types broken down into 1% As Needed, and 99% Full Time. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution.

Prior Authorization Specialist

Grace Health

Battle Creek, MI

$17 - $22.75/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 18 days ago

Grace Health (Kentucky) rating

7.8

Company rating: 7.8 out of 10

Based on 7 frontline employees who took The Breakroom Quiz

Job description

Grace Health is currently seeking an individual that will obtain prior authorizations for patients and assist with the managed care process. We offer competitive wages based on experience and up to 3 weeks of PTO in the first year! Other perks include no nights or weekend work.

$1,000 Sign-on bonus ($500 after successful completion of your probationary period and $500 after 6 months).

Benefits

  • Medical, vision, dental, life, and disability insurance
  • 401K match
  • 8 paid holidays
  • Employee wellness program focusing on physical, mental, and financial wellness

EXAMPLES OF DUTIES: (This list may not be all inclusive.)

    1. Educates patients and staff about the process of medication prior authorizations.
    2. Processes medication prior authorization requests.
    3. Communicates with patients, Grace Health staff and other offices or health care agencies regarding medication prior authorization.
    4. Develops and maintains a tracking system for medication prior authorizations.
    5. Documents appropriate information in the medical record.
    6. Maintains current resources related to medication prior authorizations.
    7. May assist staff and patients with the managed care process.

    Requirements:

    1. High school Diploma or GED

    2. Completion of Medical Terminology

    3. Ambulatory and Pharmacy experience preferred

    4. Certified Clinical Medical Assistant Preferred

    GH26


      Employment Type: FULL_TIME

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