Prior Authorization Associate
$17 - $21.25/hr
PN Access and Authorizations Full Time Day Shift M-F 8a-5p Lexington Health is a comprehensive ... Job Summary Responsible for accurately authorizing referrals prior to patient appointments.
$17 - $21.25/hr
PN Access and Authorizations Full Time Day Shift M-F 8a-5p Lexington Health is a comprehensive ... Job Summary Responsible for accurately authorizing referrals prior to patient appointments.
$17 - $21.25/hr
PN Access and Authorizations Full Time Day Shift M-F 8a-5p Lexington Health is a comprehensive ... Job Summary Responsible for accurately authorizing referrals prior to patient appointments.
Rockaway, NJ · On-site
$23 - $25/hr
Research, analyze and appropriately resolve rejected claims by working with national Medicare D ... BENEFITS for full time Employees * Medical, Dental, and Vision insurance * 401 (k) (available for ...
Rockaway, NJ · On-site
$23 - $25/hr
Research, analyze and appropriately resolve rejected claims by working with national Medicare D ... BENEFITS for full time Employees * Medical, Dental, and Vision insurance * 401 (k) (available for ...
Columbia, SC · On-site
$17 - $21.25/hr
PN Access and Authorizations Full Time Day Shift M-F 8a-5p Lexington Health is a comprehensive ... Job Summary Responsible for accurately authorizing referrals prior to patient appointments.
Columbia, SC · On-site
$17 - $21.25/hr
PN Access and Authorizations Full Time Day Shift M-F 8a-5p Lexington Health is a comprehensive ... Job Summary Responsible for accurately authorizing referrals prior to patient appointments.
Columbia, SC · On-site
$17 - $21.25/hr
PN Access and Authorizations Full Time Day Shift M-F 8a-5p Lexington Health is a comprehensive ... Job Summary Responsible for accurately authorizing referrals prior to patient appointments.
Columbia, SC · On-site
$17 - $21.25/hr
PN Access and Authorizations Full Time Day Shift M-F 8a-5p Lexington Health is a comprehensive ... Job Summary Responsible for accurately authorizing referrals prior to patient appointments.
Broadview Heights, OH · Remote
$17.50 - $23.25/hr
Pharmacy Prior Authorization Manager Job Type : Full-Time - Remote - Pharmacies: West Virginia, Ohio, Indiana and Maryland Position Overview : The Prior Authorization Specialist will maintain the ...
Broadview Heights, OH · Remote
$17.50 - $23.25/hr
Pharmacy Prior Authorization Manager Job Type : Full-Time - Remote - Pharmacies: West Virginia, Ohio, Indiana and Maryland Position Overview : The Prior Authorization Specialist will maintain the ...
San Diego, CA · On-site
$22.55 - $27.41/hr
Uses various business applications to perform analysis, obtain information, and enter prior ... Working Hours This is a full-time non-exempt position requiring one to be able to work overtime ...
San Diego, CA · On-site
$22.55 - $27.41/hr
Uses various business applications to perform analysis, obtain information, and enter prior ... Working Hours This is a full-time non-exempt position requiring one to be able to work overtime ...
Appleton, WI · On-site
$20 - $24/hr
We are seeking a full-time Prior Authorization Specialist to join our Clinical Services team. This position works Monday through Friday, 8-hour daytime shifts, with no nights, weekends, or holidays.
Appleton, WI · On-site
$20 - $24/hr
We are seeking a full-time Prior Authorization Specialist to join our Clinical Services team. This position works Monday through Friday, 8-hour daytime shifts, with no nights, weekends, or holidays.
$17.25 - $23/hr
This position is full-time workingM-F 9:00a-5:30p and 1 Saturday per month as OT (8a-12p). This ... authorization of benefit coverage * Prior experience with managed care and physician office ...
$17.25 - $23/hr
This position is full-time workingM-F 9:00a-5:30p and 1 Saturday per month as OT (8a-12p). This ... authorization of benefit coverage * Prior experience with managed care and physician office ...
Appleton, WI · On-site
$20 - $24/hr
We are seeking a full-time Prior Authorization Specialist to join our Clinical Services team. This position works Monday through Friday, 8-hour daytime shifts, with no nights, weekends, or holidays.
Quick apply
Appleton, WI · On-site
$20 - $24/hr
We are seeking a full-time Prior Authorization Specialist to join our Clinical Services team. This position works Monday through Friday, 8-hour daytime shifts, with no nights, weekends, or holidays.
Appleton, WI · On-site
$20 - $24/hr
We are seeking a full-time Prior Authorization Specialist to join our Clinical Services team. This position works Monday through Friday, 8-hour daytime shifts, with no nights, weekends, or holidays.
Appleton, WI · On-site
$20 - $24/hr
We are seeking a full-time Prior Authorization Specialist to join our Clinical Services team. This position works Monday through Friday, 8-hour daytime shifts, with no nights, weekends, or holidays.
Tempe, AZ · On-site
$22.55 - $27.41/hr
Uses various business applications to perform analysis, obtain information, and enter prior ... Working Hours This is a full-time non-exempt position requiring one to be able to work overtime ...
Tempe, AZ · On-site
$22.55 - $27.41/hr
Uses various business applications to perform analysis, obtain information, and enter prior ... Working Hours This is a full-time non-exempt position requiring one to be able to work overtime ...
Minneapolis, MN · On-site
$18.75 - $25/hr
This position is full-time working M-F 9:00a-5:30p and 1 Saturday per month as OT (8a-12p). This ... authorization of benefit coverage * Prior experience with managed care and physician office ...
Minneapolis, MN · On-site
$18.75 - $25/hr
This position is full-time working M-F 9:00a-5:30p and 1 Saturday per month as OT (8a-12p). This ... authorization of benefit coverage * Prior experience with managed care and physician office ...
Rockaway, NJ · On-site
$23 - $25/hr
Research, analyze and appropriately resolve rejected claims by working with national Medicare D ... BENEFITS for full time Employees * Medical, Dental, and Vision insurance * 401 (k) (available for ...
Rockaway, NJ · On-site
$23 - $25/hr
Research, analyze and appropriately resolve rejected claims by working with national Medicare D ... BENEFITS for full time Employees * Medical, Dental, and Vision insurance * 401 (k) (available for ...
Tempe, AZ · On-site +1
$22.55 - $27.41/hr
Uses various business applications to perform analysis, obtain information, and enter prior ... Working Hours This is a full-time non-exempt position requiring one to be able to work overtime ...
Tempe, AZ · On-site +1
$22.55 - $27.41/hr
Uses various business applications to perform analysis, obtain information, and enter prior ... Working Hours This is a full-time non-exempt position requiring one to be able to work overtime ...
Frisco, TX · On-site
Revenue Cycle / Operations Schedule: Full-Time, Monday-Friday Location: On-Site, Plano / Frisco The ... Own denial and appeal workflows, including root-cause analysis, clinical documentation coordination ...
Quick apply
Frisco, TX · On-site
Revenue Cycle / Operations Schedule: Full-Time, Monday-Friday Location: On-Site, Plano / Frisco The ... Own denial and appeal workflows, including root-cause analysis, clinical documentation coordination ...
Ocala, FL · On-site
$17.25 - $21.50/hr
Biologics/Prior Authorization Coordinator Summary ... This is a full-time position. This position is eligible for health insurance, paid time off, 401k ...
Quick apply
Ocala, FL · On-site
$17.25 - $21.50/hr
Biologics/Prior Authorization Coordinator Summary ... This is a full-time position. This position is eligible for health insurance, paid time off, 401k ...
$29K - $33K/yr
Verify prior authorization and/or pre-service requirements are met * Manage and maintain all ... Analytical ability to apply criteria and evaluate information to make decisions * Strong verbal and ...
$29K - $33K/yr
Verify prior authorization and/or pre-service requirements are met * Manage and maintain all ... Analytical ability to apply criteria and evaluate information to make decisions * Strong verbal and ...
Monitor and analyze prior authorization performance metrics, turnaround times, and cost-savings impact. * Develop and deliver regular operational and performance reports for internal leadership and ...
Quick apply
Monitor and analyze prior authorization performance metrics, turnaround times, and cost-savings impact. * Develop and deliver regular operational and performance reports for internal leadership and ...
Orlando, FL · On-site
Monitor and analyze prior authorization performance metrics, turnaround times, and cost-savings impact. * Develop and deliver regular operational and performance reports for internal leadership and ...
Quick apply
Orlando, FL · On-site
Monitor and analyze prior authorization performance metrics, turnaround times, and cost-savings impact. * Develop and deliver regular operational and performance reports for internal leadership and ...
Saint Cloud, MN · On-site
$21.12 - $31.68/hr
The Prior Authorization team processes all health plan/payer utilization review requirements, which ... Schedule: * Full-time | 80 hours every two weeks * Day shift | 8-hour shifts | 8am-4:30pm Pay and ...
Saint Cloud, MN · On-site
$21.12 - $31.68/hr
The Prior Authorization team processes all health plan/payer utilization review requirements, which ... Schedule: * Full-time | 80 hours every two weeks * Day shift | 8-hour shifts | 8am-4:30pm Pay and ...
$31K - $40K
11% of jobs
$40K - $49K
9% of jobs
$52.1K is the 25th percentile. Wages below this are outliers.
$49K - $58K
15% of jobs
$58K - $67K
15% of jobs
The median wage is $67.3K / yr.
$67K - $76K
18% of jobs
$82.5K is the 75th percentile. Wages above this are outliers.
$76K - $85K
11% of jobs
$85K - $94K
7% of jobs
$94K - $103K
5% of jobs
$103K - $112K
4% of jobs
$112K - $121K
2% of jobs
$121K - $130K
3% of jobs
$31K
$73.3K
$130K
| Aspect | Full Time Prior Authorization Analyst | Medical Claims Processor |
|---|---|---|
| Credentials | Typically requires healthcare-related certifications or experience | Often requires knowledge of billing and coding, but fewer certifications |
| Work Environment | Healthcare offices, insurance companies, or hospital settings | Insurance companies, healthcare providers, or billing departments |
| Job Focus | Reviewing and approving prior authorization requests for treatments or procedures | Processing and reviewing medical claims for reimbursement |
The Full Time Prior Authorization Analyst primarily focuses on evaluating and approving requests for medical procedures before treatment, ensuring compliance with insurance policies. In contrast, the Medical Claims Processor handles the processing of claims after services are provided, verifying accuracy and facilitating reimbursement. While both roles require healthcare knowledge, the analyst role emphasizes authorization and compliance, whereas the claims processor centers on claims management and billing.

$17 - $21.25/hr
Full-time
Medical, Dental, Life, Retirement
Re-posted 26 days ago
6.9
Based on 104 frontline employees who took The Breakroom Quiz
551st of 1,056 rated hospitals
PN Access and Authorizations
Full Time
Day Shift
M-F 8a-5p
Lexington Health is a comprehensive network of care that includes six community medical and urgent care centers, nearly 80 physician practices, more than 9,000 health care professionals and Lexington Medical Center, a 607-bed teaching hospital in West Columbia, South Carolina. It was selected by Modern Healthcare as one of the Best Places to Work in Healthcare and was first in the state to achieve Magnet with Distinction status for excellence in nursing care. Consistently ranked as best in the Columbia Metro area by U.S. News & World Report, Lexington Health delivers more than 4,000 babies each year, performs more than 34,000 surgeries annually and is the region's third largest employer.
Lexington Health also includes an accredited Cancer Center of Excellence, the state's first HeartCARE Center, the largest skilled nursing facility in the Carolinas, and an Alzheimer's care center. Its postgraduate medical education programs include family medicine and transitional year residencies, as well as an informatics fellowship.
Responsible for accurately authorizing referrals prior to patient appointments. Utilizes Epic Referral Work Queues, Experian Real Time Authorization (RTA), phone, payer websites and fax to complete prior authorizations for imaging and specialty services. Communicates authorization updates to appropriate departments. Verifies all pertinent clinical information is submitted in order for authorization to be processed accurately. Documents all information within the referral record and chart in Epic to include approvals, denials, peer-to-peers and pending authorizations.
Minimum Education: High School Diploma or Equivalent
Minimum Years of Experience: 6 months of referral and/or authorization experience
Substitutable Education & Experience: None.
Required Certifications/Licensure: None.
Required Training: Strong Medical Terminology and Insurance Knowledge; Knowledge of ICD-10 and CPT Coding
We are committed to offering quality, cost-effective benefits choices for our employees and their families:
Equal Opportunity Employer
It is the policy of Lexington Health to provide equal opportunity of employment for all individuals, and to remain compliant with applicable state and federal laws and regulations. Lexington Health strives to provide a discrimination-free environment, and to recruit, select, on-board, and employ all employees without regard to race, color, religion, sex, age, disability, national origin, veteran status, or pregnancy, childbirth, or related medical conditions, including but not limited to, lactation. Lexington Health endeavors to upgrade and promote employees from within the hospital where possible and consistent with the employee's desires and abilities and the hospital's needs.
Get the full story on Breakroom
Sourced by ZipRecruiter
Health care and social assistance
5,001 - 10,000 Employees
West Columbia, SC, US
1971