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Medical Billing Prior Authorization Jobs in Decatur, GA

PainPoint

Prior Authorization Coordinator

Atlanta, GA · On-site +1

$19 - $21/hr

Review medical necessity guidelines for procedures by Paycor. * Accurately and promptly submit prior and retro authorization requests to payors. * Document account activity, updating patient and ...

PainPoint

Prior Authorization Team Lead

Atlanta, GA · On-site +1

$23/hr

Prior Authorization Team Lead Full-Time | Remote | $23/hr Schedule: Monday-Friday 8:00 AM-4:30 PM ... Review payer medical necessity guidelines and authorization requirements. * Communicate with ...

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Medical Billing Prior Authorization information

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How much do medical billing prior authorization jobs pay per hour?

As of Jul 15, 2026, the average hourly pay for medical billing prior authorization in Decatur, GA is $20.03, according to ZipRecruiter salary data. Most workers in this role earn between $17.12 and $22.07 per hour, depending on experience, location, and employer.

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

To thrive as a Medical Billing Prior Authorization Specialist, you need a solid understanding of medical terminology, insurance processes, and healthcare regulations, often supported by experience in medical billing or a related certification. Familiarity with electronic health record (EHR) systems, payer portals, and billing software is typically required. Attention to detail, problem-solving abilities, and effective communication skills help you navigate complex approvals and coordinate with providers and insurance companies. These skills ensure accurate, timely authorizations that support patient care and efficient healthcare operations.

What is medical billing prior authorization?

Medical billing prior authorization is a process where healthcare providers obtain approval from a patient's insurance company before delivering certain medical services, procedures, or medications. This step is required to ensure that the insurance plan will cover the requested service, helping to prevent claim denials and unexpected costs for patients. The process typically involves submitting detailed clinical information to the insurer, who then reviews it to determine if the service is medically necessary. Prior authorization helps control healthcare costs and ensures appropriate care, but it can sometimes delay treatment if not handled efficiently.

What is the difference between Medical Billing Prior Authorization vs Medical Coding Specialist?

AspectMedical Billing Prior AuthorizationMedical Coding Specialist
CredentialsTypically requires certification in medical billing or coding, such as CPC or CPC-HRequires coding certifications like CPC, CCS, or CCS-P
Work EnvironmentOffice-based, healthcare provider or insurance companyOffice-based, healthcare facilities or billing companies
Primary ResponsibilitiesSecuring prior approvals for procedures and treatmentsAssigning standardized codes to diagnoses and procedures
Industry UsageCommonly used in medical billing and insurance claimsUsed in medical billing, coding, and health information management

While both roles involve medical billing processes, Medical Billing Prior Authorization focuses on obtaining approval for procedures, whereas Medical Coding Specialists assign codes to diagnoses and treatments. Both require similar certifications and work environments, but their core functions differ within the billing cycle.

What are some common challenges faced in a Medical Billing Prior Authorization role, and how can they be managed?

Professionals in Medical Billing Prior Authorization often encounter challenges such as navigating complex insurance requirements, managing frequent updates to payer policies, and dealing with time-sensitive approvals. Staying organized and maintaining up-to-date knowledge of insurance guidelines is key to success. Building strong communication skills is also essential, as the role requires frequent coordination with healthcare providers, insurance companies, and patients to resolve issues efficiently.
What are popular job titles related to Medical Billing Prior Authorization jobs in Decatur, GA? For Medical Billing Prior Authorization jobs in Decatur, GA, the most frequently searched job titles are:
What job categories do people searching Medical Billing Prior Authorization jobs in Decatur, GA look for? The top searched job categories for Medical Billing Prior Authorization jobs in Decatur, GA are:
What cities near Decatur, GA are hiring for Medical Billing Prior Authorization jobs? Cities near Decatur, GA with the most Medical Billing Prior Authorization job openings:
Medical Billing Prior Authorization jobs near you
Prior Authorization Coordinator

Prior Authorization Coordinator

Soleo Health Inc

Atlanta, GA • On-site, Remote

$20 - $23/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 2 days ago

Job description

Description

Soleo Health is seeking a Prior Authorization Coordinator to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care!


Specialty infusion prior authorization experience required. Hours are Monday-Friday 9:00am - 5:30pm Eastern Standard time.


Soleo Health Perks:

  • Competitive Wages
  • 401(k) with a Match
  • Referral Bonus
  • Paid Time Off
  • Great Company Culture
  • Annual Merit Based Increases
  • No Weekends or Holidays
  • Paid Parental Leave Options
  • Affordable Medical, Dental, & Vision Insurance Plans
  • Company Paid Disability & Basic Life Insurance
  • HSA & FSA (including dependent care) Options
  • Education Assistance Program


The Position:

The Prior Authorization Coordinator ensures seamless patient care by maintaining prior authorizations, copay assistance, and verifying existing insurance coverage for ongoing services. Responsibilities include:

  • Must have a solid working knowledge of insurance plans and benefit structures in order to obtain detailed benefit information and maximize plan benefits
  • Verify insurance benefit information monthly via multiple methods such as online tools, calling payors or processing test claims
  • Generates a prior authorization expiration report weekly, bi-weekly, or monthly
  • Review clinical documents for prior authorization/pre-determination submission purposes
  • Secures prior authorization, pre-determination, or medical review
  • Contact prescriber's office to obtain information that is required to complete ongoing re-authorization and verification of benefits
  • Places outbound calls to patients or prescriber's offices to notify of any delays due to more information needed to process or due to a prior authorization
  • Document insurance coverage of medications, administration supplies, and related infusion services including prior authorization requirements and coordination of benefits
  • Provides exceptional customer service to external and internal customers, resolving any customer requests in a timely and accurate manner
  • Ensures the appropriate notification of patients in regards to their financial responsibility, benefit coverage, and payor authorization for services to be provided
  • Generates patient forms
  • Maintains up to date prior authorization report


Schedule:

  • Monday-Friday 9:00am-5:30pm Eastern Standard Time

Requirements

  • High school diploma or equivalent required.
  • At least 2 years of healthcare intake/admissions and/or reimbursement experience
  • Previous medical and pharmacy benefit experience is required
  • Initiating and securing prior authorizations, pre-determination, and appeals
  • Ability to interpret payor contract fee schedules based on NDC and HCPCS units
  • Ability to effectively handle multiple priorities within a changing environment
  • Basic level skill in Microsoft Excel
  • Basic level skill in Microsoft Word


About Us: Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference!


Soleo's Core Values:

  • Improve patients' lives every day
  • Be passionate in everything you do
  • Encourage unlimited ideas and creative thinking
  • Make decisions as if you own the company
  • Do the right thing
  • Have fun!


Soleo Health is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture.


Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor.


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