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Insurance Prior Authorization Jobs in New York (NOW HIRING)

Claim Health

Prior Authorization Specialist

New York, NY · On-site

$19.75 - $26.25/hr

Prior authorization is one of the largest operational bottlenecks for agencies. Our platform ... Deep familiarity with Medicare Advantage, Medicaid, managed Medicaid, commercial insurance, and ...

Medix

Prior Authorization Representative

New York, NY

$22 - $28/hr

* Submit and track Medicare prior authorization requests through Noridian and CGS payer portals. * Monitor authorization statuses and perform timely follow-up on pending or additional documentation ...

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Insurance Prior Authorization information

See New York salary details

$27.9K

$71.8K

$91.4K

How much do insurance prior authorization jobs pay per year?

As of Aug 30, 2026, the average yearly pay for insurance prior authorization in New York is $71,825.00, according to ZipRecruiter salary data. Most workers in this role earn between $66,700.00 and $84,200.00 per year, depending on experience, location, and employer.

What is insurance prior authorization?

Insurance prior authorization is a process where healthcare providers must obtain approval from a patient's insurance company before performing certain medical procedures, prescribing medications, or providing specific services. This ensures that the recommended treatment is covered under the patient's insurance plan and is deemed medically necessary. The process may involve submitting clinical information and waiting for a decision from the insurance provider. Prior authorization is intended to control costs and ensure appropriate care, but it can sometimes delay access to treatment.

What are the key skills and qualifications needed to thrive in insurance prior authorization?

To thrive in Insurance Prior Authorization, you need a solid understanding of medical terminology, insurance policies, and healthcare regulations, often supported by experience in a healthcare or insurance setting. Familiarity with electronic health record (EHR) systems, insurance portals, and authorization management software is typically required. Attention to detail, strong organizational skills, and effective communication are critical soft skills for managing complex cases and coordinating with providers and payers. These competencies ensure timely approvals, reduce claim denials, and improve patient access to necessary medical treatments.

What are some common challenges faced in an insurance prior authorization role, and how can they be effectively managed?

One of the main challenges in Insurance Prior Authorization is navigating the varying requirements and documentation standards of different insurance providers. This often requires staying updated on policy changes and maintaining close attention to detail to prevent delays or denials. Effective communication with healthcare providers and insurance representatives is also essential, as misunderstandings or incomplete information can slow down the process. Building strong organizational skills and using robust tracking systems can help manage workloads and ensure timely approvals, ultimately supporting patient care.

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

AspectInsurance Prior AuthorizationInsurance Claims Specialist
Required CredentialsKnowledge of insurance policies, healthcare regulationsUnderstanding of claims processing, coding, documentation
Work EnvironmentHealthcare providers, insurance companies, hospitalsInsurance companies, healthcare organizations, billing departments
Employer & Industry UsageUsed to approve coverage before services are renderedHandles post-service claims, reimbursement processing
Search & Comparison IntentUnderstanding pre-authorization processClaims processing and reimbursement procedures

Insurance Prior Authorization involves obtaining approval from insurance companies before healthcare services are provided, ensuring coverage. In contrast, Insurance Claims Specialists process claims after services are rendered to secure payment. Both roles require knowledge of insurance policies but focus on different stages of the insurance process.

Are insurance prior authorization jobs in high demand?

Insurance prior authorization jobs are in steady demand due to the ongoing need for healthcare cost management and insurance processing. These roles often require strong organizational skills and familiarity with insurance policies and medical billing systems, making them a stable career option in the healthcare administration field.

How to become an insurance prior authorization specialist?

To become an insurance prior authorization specialist, candidates typically need a high school diploma or equivalent, along with experience in healthcare or insurance billing. Relevant skills include knowledge of insurance policies, medical terminology, and proficiency with electronic health record (EHR) systems; certifications such as the Certified Professional Coder (CPC) can enhance job prospects.

Is insurance prior authorization a stressful job?

Insurance prior authorization is often considered a stressful job due to the need for accuracy, attention to detail, and managing multiple cases under tight deadlines. Employees frequently handle complex documentation and communicate with healthcare providers and insurance companies, which can contribute to work-related stress. Strong organizational skills and familiarity with insurance policies can help mitigate some of these challenges.

What are the most commonly searched types of Insurance Prior Authorization jobs in New York?

The most popular types of Insurance Prior Authorization jobs in New York are:

Insurance Prior Authorization jobs near you
Infographic showing various Insurance Prior Authorization job openings in New York as of August 2026, with employment types broken down into 1% As Needed, 73% Full Time, 21% Part Time, and 5% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $71,825 per year, or $34.5 per hour.

Referrals and Prior Authorization Specialist

LaSante Health Center

Brooklyn, NY

$19 - $21/hr

Full-time

Re-posted 14 days ago

Job description

LaSante Health Center is seeking a Referrals and Prior Authorization Specialist to join our team. The ideal candidate will help ensure patients have seamless access to medications, diagnostic imaging, and specialty care by managing prior authorization requests for insurance and guiding patients through the referral process. This position offers the opportunity to be part of a mission-driven, community-focused organization dedicated to delivering patient-centered care with compassion and respect.

Key Responsibilities

  • Manage prior authorization requests from insurance companies for medications, diagnostic imaging, and procedures.

  • Process provider referrals promptly and ensure patients have timely access to specialty and imaging services.

  • Offer patients options for in-network providers who are convenient to their homes and aligned with their preferences.

  • Provide clear communication and assistance to patients in scheduling appointments with outside specialists or imaging facilities.

  • Collaborate with healthcare providers, insurers, and patients to eliminate barriers to care.

  • Maintain accurate records and track the status of authorizations and referrals.

  • Perform additional duties as assigned by supervisors.

Qualifications

  • Strong organizational skills and ability to multitask

  • Excellent communication and customer service skills

  • Proficiency with computers and ability to learn healthcare systems quickly

  • Experience with insurance prior authorizations and/or medical referrals preferred

  • Knowledge of health plan networks and medical terminology is a plus