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Insurance Prior Authorization Jobs in Virginia (NOW HIRING)

Riverside

$23.90 - $31.10/hr

Timely process of referrals and submit clinical supporting documentation to insurance carriers, manufacturers, or foundations to expedite prior authorization and/or patient assistance processes.

County Med LLC

Be Seen First

Certified Medical Assistant

Blackstone, VA · On-site

$17.75 - $23/hr

Experience with insurance prior authorizations and referrals. * Experience performing phlebotomy and administering injections. * Familiarity with quality reporting measures and preventive care ...

New

County Med LLC

Be Seen First

Certified Medical Assistant

Blackstone, VA · On-site

$17.75 - $23/hr

Experience with insurance prior authorizations and referrals. * Experience performing phlebotomy and administering injections. * Familiarity with quality reporting measures and preventive care ...

New

Summit BHC

Intake Clinician-Nights

Williamsburg, VA · On-site

$36K - $41K/yr

Facilitates intake, admission, and prior authorization process for incoming patients. * Performs insurance benefit verifications, disseminating the information gathered to patients, their families ...

Summit BHC

Intake RN-PRN

Williamsburg, VA · On-site

$36K - $41K/yr

Facilitates intake, admission, and prior authorization process for incoming patients. * Performs insurance benefit verifications, disseminating the information gathered to patients, their families ...

HORIZON HEALTH SERVICES INC

LPN/MA

Dendron, VA · On-site

$45K - $70K/yr

Obtain and manage prior authorizations as required by insurance carriers. * Follow up on referral status and ensure receipt of consultation reports. * Communicate referral information, appointment ...

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Showing results 21-40

All JobsInsurance Prior Authorization JobsInsurance Prior Authorization Jobs in Virginia

Insurance Prior Authorization information

See Virginia salary details

$25.3K

$65.1K

$82.8K

How much do insurance prior authorization jobs pay per year?

As of Aug 2, 2026, the average yearly pay for insurance prior authorization in Virginia is $65,088.00, according to ZipRecruiter salary data. Most workers in this role earn between $60,500.00 and $76,300.00 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.

Is prior authorization a stressful job?

Insurance prior authorization is often considered a stressful role due to the need for accuracy, meeting strict deadlines, and handling complex cases. The job requires strong attention to detail, communication skills, and familiarity with insurance policies and medical documentation, which can contribute to work-related stress.

What are the key skills and qualifications needed to thrive in Insurance Prior Authorization, and why are they important?

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.

How much do precertification specialists make?

Precertification specialists typically earn between $35,000 and $55,000 annually, depending on experience, location, and employer. They often require knowledge of insurance policies and may use claims processing software as part of their role.

What jobs pay 4000 a week without a degree?

Insurance prior authorization specialists typically do not earn $4,000 weekly without relevant experience or certifications. High-paying roles that can reach this level often include sales positions, real estate brokers, or skilled trades like certain construction or electrical work, which may require licenses but not necessarily a college degree. These jobs often demand strong skills, experience, or licensing rather than formal education.

How to become a prior authorization specialist?

To become a prior authorization specialist, candidates typically need a high school diploma or equivalent, along with knowledge of insurance policies and medical terminology. Relevant skills include attention to detail, communication, and familiarity with electronic health record (EHR) systems. Certification in medical billing or coding can enhance job prospects.

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.

What are the most commonly searched types of Insurance Prior Authorization jobs in Virginia? The most popular types of Insurance Prior Authorization jobs in Virginia are:
Insurance Prior Authorization jobs near you
Infographic showing various Insurance Prior Authorization job openings in Virginia as of July 2026, with employment types broken down into 93% Full Time, 5% Part Time, and 2% Contract. Highlights an 95% In-person, 2% Hybrid, and 3% Remote job distribution, with an average salary of $65,088 per year, or $31.3 per hour.

Specialty Pharmacy Technician

Riverside

Newport News, VA

$23.90 - $31.10/hr

Part-time

Posted 5 days ago

Job description

Newport News, Virginia

Hiring Range

$23.90 - $31.10/Hourly Actual pay is determined based on job-related factors such as relevant experience, education, credentials, skills, internal equity, and business needs.
Overview
A Specialty Medication Coordinator is responsible for performing tasks related to the management of third-party billing or patient financial assistance for patients within the health system. A Specialty Medication Coordinator assists with managing and processing high dollar specialty medications (e.g. oncology, infectious disease, multiple sclerosis) and may be responsible for benefits investigation, obtaining prior authorizations, copay/foundation assistance, drug replacement services, and patient financial counseling. Additional activities may include patient onboarding, order entry, financial tracking, patient care coordination, medication ordering/tracking, cold chain distribution and shipping activities.
What you will do
  • Timely process of referrals and submit clinical supporting documentation to insurance carriers, manufacturers, or foundations to expedite prior authorization and/or patient assistance processes. Collaborate with other departments to assist in obtaining prior authorizations, patient assistance medications or financial assistance. Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed. Follows prior authorization and/or patient assistance workflows and policies/procedures.
  • Demonstrates the ability to work independently, meet deadlines and possesses excellent time management skills. Perform tasks accurately and efficiently. Possesses excellent interpersonal, customer service and communication skills (both written and verbal); timely responses to key stakeholders.
  • Accurate documentation of all intake referrals and/or prior authorization information in patient medical record or patient assistance tracking software in compliance with policy and procedure/workflow. Completes timely documentation within the required tracking systems and retrieves necessary documentation and maintains up to date knowledge of the pharmaceutical companies' patient assistance programs.
  • Proactively tracks and manages patient refills/outreach to ensure timely prescription/infusion service.
  • Proactively works on prior authorization and patient assistance enrollments that are due to expire.
  • Secure patients' demographic and medical information in compliance with organization HIPAA policies and procedures.
  • Assists management with inspections, audits, reports and training to ensure compliance with standards and to provide quality service.

Qualifications
Education
  • Program Graduate, Pharmacy Technician Training Program or equivalent (Preferred) or
  • Program Graduate, Licensed Practical Nurse (Required) or
  • Program Graduate, Certified Medical Assistant (Required)

Experience
  • 3-4 years Experience as a Pharmacy Technician, LPN or CMA (in lieu of education) (Required)
  • 1 year Experience obtaining and managing medication prior authorization as part of job function (Preferred)
  • 1 year Prior Experience obtaining and managing patient assistance program applications (Preferred)

Skills and Abilities
  • Familiar with medical and pharmacy terminology
  • Prescription drug and over-the-counter knowledge
  • Basic math skills, including pharmaceutical calculations
  • Basic pharmacy workflow
  • Understanding pharmacy computer systems
  • Ability to navigate and read electronic health record
  • Strong written and verbal communication skills
  • Ability to prioritize, problem solve and multitask
  • Excellent customer service skills
  • Knowledge of patient assistance programs
  • Experience with prior authorization of medications
  • Strong organizational skills and detail oriented

Licenses and Certifications
  • Registered Pharmacy Technician - Virginia Department of Health Professions (VDHP) Upon Hire(Required) and
  • Pharmacy Technician Certification Board (PTCB) - Pharmacy Technician Certification Board (PTCB) PTCB or ExCPT Upon Hire(Required) or
  • Licensed Practical Nurse (LPN) - Virginia Department of Health Professions (VDHP) Upon Hire(Required) or
  • Certified Medical Assistant (CMA) - American Association of Medical Assistants (AAMA) Upon Hire(Required)
  • Advanced certification in specialty pharmacy field (PTCB, ASHP, NCODA and other approved programs) (Preferred)

To learn more about being a team member with Riverside Health System visit us at https://www.riversideonline.com/careers.

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