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Insurance Prior Authorization Jobs in Detroit, MI

North West Labs

Genetic Testing Coordinator

Sterling Heights, MI · On-site

$18 - $20/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Obtain insurance prior authorizations and verify patient coverage as needed * Collect oral swab specimens following proper collection protocols and procedures * Travel locally between multiple office ...

North West Labs

Genetic Testing Coordinator

Southfield, MI · On-site

$22 - $24/hr

  • Medical

  • Vision

  • Retirement

  • PTO

Obtain insurance prior authorizations and verify patient coverage as needed * Collect oral swab specimens following proper collection protocols and procedures * Travel between multiple office ...

Cgm

Authorization and Denials Coordinator

Bloomfield Hills, MI · Hybrid

$17.75 - $22/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Own the full authorization cycle- verify insurance eligibility and benefits, gather clinical documentation, submit prior authorization requests, and track pending approvals daily to prevent ...

Synergy Health Partners MSO, LLC

Be Seen First

Insurance Verification Specialist

Troy, MI · On-site

$18 - $22/hr

  • Medical

  • Dental

  • Vision

  • Retirement

Obtain prior authorization and verification of eligibility from insurance carrier for office visits, procedures, and MRI's. * Investigate and interprets all incoming insurance information regarding ...

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All JobsInsurance Prior Authorization JobsInsurance Prior Authorization Jobs in Detroit, MI

Insurance Prior Authorization information

See Detroit, MI salary details

$25.2K

$65K

$82.7K

How much do insurance prior authorization jobs pay per year?

As of Aug 18, 2026, the average yearly pay for insurance prior authorization in Detroit, MI is $64,993.00, according to ZipRecruiter salary data. Most workers in this role earn between $60,400.00 and $76,200.00 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.
Insurance Prior Authorization jobs near you
Infographic showing various Insurance Prior Authorization job openings in Detroit, MI as of August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 20% Part Time, and 5% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $64,993 per year, or $31.2 per hour.

Infusion Prior Authorization Specialist

M.I.N.D

Farmington, MI • On-site

$19 - $25/hr

Full-time

Re-posted 23 days ago

Job description

Job Description – Infusion Prior Authorization Specialist

Classification – FSLA - Non-Exempt - hourly

Salary Grade/Level/Range

Level of experience, longevity, within current company pay structure.

Reports to

Revenue Cycle Manager


Summary/Objective

Responsible for ensuring all pre-service accounts are financially cleared and secured prior to the date of service. The specialist is responsible for obtaining and verifying accurate insurance information, benefit validation, and authorizations. This is a key position that begins the overall patient experience and initiates the billing process for any services provided by the practice.

Essential Functions

  • Contact insurance carriers utilizing telephone and/or payer websites to verify patient eligibility, benefits, authorization requirements.
  • Ensure all patients are compliant w/individual criteria for both the drug manufacture and insurance company medical policy.
  • Determine procurement methods such as buy and bill, specialty pharmacy, or pharmaceutical free drug program.
  • Coordinate delivery of infusion medications based on procurement method.
  • Coordinate with Infusion scheduler to ensure patients are scheduled promptly
  • Follow up on pending patients' status regularly to ensure timely completion of script to chair.
  • Request, track and obtain pre-authorizations prior to services being performed.
  • Apply knowledge of medical terminology and general medical office procedures.
  • Communicate any insurance coverage and/or authorization changes or trends among team.
  • Maintain level of productivity suitable for the department.
  • Clearly document all communications and contacts with providers and personnel in standardized documentation requirements, including proper format.

Qualities and Characteristics

  • Maintains a professional relationship and positive attitude with co-workers, patients and all M.I.N.D staff.
  • Strives to learn more and receptive to new challenges and opportunities.
  • Displays enthusiasm toward the work and the mission of M.I.N.D.

Qualifications

  • High School Diploma or GED.
  • Demonstrated knowledge of insurances
  • 1+ year experience in insurance verification, including navigating websites for online benefit review.
  • Knowledge of CPT and ICD-10 codes.
  • Excellent computer, multi-tasking and phone skills.
  • The ability to work well under pressure to address time sensitive deadlines.
  • Problem solving, time management and exceptional interpersonal skills.

Work Environment
This job operates in a medical office facility.

Physical Demands

This position requires the ability to sit for long periods of time, view computer screens for long period of time, answer calls on a multi-line phone system, writing, reading and note taking.

Position Type/Expected Hours of Work
This is a full-time position; fully remote after successful completion of training period. Days and hours of work are Monday through Friday, varying hours between 8:00 a.m. to 4:30 p.m.

  • Travel – none

Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Employees should adhere to all approved policies, procedures and philosophies.

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