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Medical Billing Prior Authorization Jobs (NOW HIRING)

1840 & Company

$16.75 - $22.25/hr

Prior Authorization Specialist We are seeking a detail-oriented and experienced Prior Authorization ... Medical billing experience * Familiarity with various commercial and government payer systems (e.g ...

Medix

Prior Authorization Specialist

Phoenix, AZ · On-site

$20 - $24/hr

Hiring Prior Authorization Specialist in Phoenix Responsibilities * Communicates with insurance ... Medical Billing and Coding Diploma Schedule/Shift * M-F 8:00-4:30pm (they can skip lunch break if ...

Urology Centers of Alabama

Prior Authorization

Birmingham, AL · On-site

$16.75 - $22.50/hr

Ensure all prior authorization submissions and supporting documentation accurately reflect the patient's medical record and comply with payer requirements. Physical Demands The physical demands ...

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

As of Aug 6, 2026, the average hourly pay for medical billing prior authorization in the United States is $20.52, according to ZipRecruiter salary data. Most workers in this role earn between $17.55 and $22.60 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?

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.
More about Medical Billing Prior Authorization jobs
What cities are hiring for Medical Billing Prior Authorization jobs? Cities with the most Medical Billing Prior Authorization job openings:
What states have the most Medical Billing Prior Authorization jobs? States with the most job openings for Medical Billing Prior Authorization jobs include:
What job categories do people searching Medical Billing Prior Authorization jobs look for? The top searched job categories for Medical Billing Prior Authorization jobs are:
Medical Billing Prior Authorization jobs near you
Infographic showing various Medical Billing Prior Authorization job openings in the United States as of August 2026, with employment types broken down into 73% Full Time, and 27% Contract. Highlights an 91% In-person, and 9% Remote job distribution, with an average salary of $42,673 per year, or $20.5 per hour.

Prior Authorization Specialist

1840 & Company

Remote

$16.75 - $22.25/hr

Full-time

Re-posted 6 days ago

Job description

Prior Authorization Specialist

We are seeking a detail-oriented and experienced Prior Authorization Specialist to manage the full lifecycle of prior authorizations (PAs) for medical services. The ideal candidate will be responsible for timely submission, meticulous follow-up, and effective resolution of all prior authorization requests and subsequent appeals. This role is critical in ensuring patients receive necessary services without delay and in maximizing reimbursement for the practice.

Key Responsibilities

  • Prior Authorization Submission and Monitoring:
  • Monitor the Prior Authorization queue and manage an organized list of outstanding and in-progress PAs
  • Review patient and service data provided by the biller/clinical team for completeness and accuracy
  • Submit new prior authorizations to the correct insurance company and plan efficiently via the required method, including insurance portals, fax, or telephone
  • Status Follow-Up:
  • Proactively and consistently call insurance companies to check on the status of submitted prior authorizations to prevent processing delays
  • Document all communication and status updates clearly and promptly in the patient management system
  • Denial Management and Appeals:
  • Identify, prepare, and submit prior authorization denial appeals in a timely manner, gathering all necessary clinical and administrative documentation
  • Track the status of all submitted appeals through resolution
  • System and Documentation Updates:
  • Monitor the designated fax inbox or electronic queue for prior authorization approvals, denials, and requests for additional information
  • Promptly update the patient management system with the final PA status, authorization number, and expiration date upon receipt of approval

Key Skills

  • Exceptional Attention to Detail: Crucial for accurately submitting data and preparing appeals.
  • Strong Communication Skills: Excellent verbal and written communication skills for professional interaction with insurance representatives and clinical staff
  • English Speaking: Fluency in English is required to effectively communicate with insurance representatives and team members.
  • Organizational and Time Management Skills: Ability to prioritize a high volume of PA requests and follow-up tasks under deadlines
  • Problem-Solving: Resourcefulness in troubleshooting issues with insurance company portals or processes.
  • Team Player: Ability to work collaboratively with billing and clinical teams to achieve patient care goals.
  • Medical billing experience
  • Familiarity with various commercial and government payer systems (e.g., Medicare, Medicaid, and major commercial insurers)
  • Proven knowledge of medical terminology, CPT codes, and ICD-10 codes

$4 - $5.50 an hour

About 1840 & Company

1840 & Company is a global leader in Business Process Outsourcing (BPO) and remote talent solutions, dedicated to propelling businesses forward through our comprehensive suite of services. We specialize in connecting companies with world-class freelance professionals and delivering top-tier outsourcing services, across over 150 countries worldwide.

Our mission is to empower growth for forward-thinking businesses, seamlessly bridging any skill or resource gaps with our expertly vetted talent pool. We firmly believe in fostering an environment where exceptional individuals can achieve an optimal work-life balance, working remotely from any location, while maximizing their professional growth and earning potential.

We are headquartered in Overland Park, KS, USA with service delivery facilities in the Philippines, India, Ukraine, South Africa and Argentina.

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