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Medical Pre Authorization Jobs (NOW HIRING)

Carle Health

Lead Pre-Authorization Specialist

Champaign, IL · On-site

$18 - $24/hr

Overview Assists in leading the daily activities of the Revenue Cycle Pre-Authorization to ensure ... Carle BroMenn Medical Center, Carle Foundation Hospital, Carle Health Methodist Hospital, Carle ...

Carle Health

Lead Pre-Authorization Specialist

$18.50 - $24.50/hr

Overview Assists in leading the daily activities of the Revenue Cycle Pre-Authorization to ensure ... Carle BroMenn Medical Center, Carle Foundation Hospital, Carle Health Methodist Hospital, Carle ...

Carle Health

Lead Pre-Authorization Specialist

Champaign, IL · On-site +1

$16.75 - $22.50/hr

OverviewAssists in leading the daily activities of the Revenue Cycle Pre-Authorization to ensure ... Carle BroMenn Medical Center, Carle Foundation Hospital, Carle Health Methodist Hospital, Carle ...

SMI IMAGING LLC

Pre-Authorization Representative

Orlando, FL · On-site

$15.75 - $20.25/hr

What You Bring Insurance and authorization expertise: You verify insurance coverage, obtain pre ... At SimonMed Imaging, we offer: • Competitive wages • No nights/no calls/no weekends • Medical ...

SimonMed Imaging

Pre-Authorization Representative

Orlando, FL · On-site

$16 - $20.25/hr

What You Bring Insurance and authorization expertise: You verify insurance coverage, obtain pre ... At SimonMed Imaging, we offer: • Competitive wages • No nights/no calls/no weekends • Medical ...

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How much do medical pre authorization jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for medical pre authorization in the United States is $19.80, according to ZipRecruiter salary data. Most workers in this role earn between $15.38 and $20.19 per hour, depending on experience, location, and employer.

What is medical pre-authorization?

Medical pre-authorization, sometimes called prior authorization, is a process used by health insurance companies to determine if they will cover a prescribed procedure, service, or medication. Before certain medical treatments are provided, your healthcare provider must obtain approval from your insurance company to ensure the service is medically necessary. This step helps control healthcare costs and ensures that patients receive appropriate care. The process may require submitting documentation about your medical condition and the proposed treatment, which can take several days to complete.

What are the key skills and qualifications needed to thrive as a medical pre-authorization specialist?

To thrive as a Medical Pre-Authorization Specialist, you need a solid understanding of medical terminology, insurance policies, and healthcare regulations, often supported by a high school diploma or an associate’s degree in healthcare administration. Familiarity with electronic health record (EHR) systems, insurance verification platforms, and prior authorization software is typically required. Attention to detail, strong organizational skills, and effective communication are crucial soft skills for excelling in this role. These abilities ensure accurate, timely processing of pre-authorizations, prevent claim denials, and support efficient patient care delivery.

What are some common challenges faced by medical pre-authorization specialists, and how can they be addressed?

Medical Pre Authorization specialists often face challenges such as navigating complex insurance policies, managing a high volume of authorization requests, and ensuring timely approval to avoid delays in patient care. To address these challenges, it's important to stay updated on payer guidelines, develop strong organizational skills, and maintain clear communication with healthcare providers and insurance representatives. Many organizations also offer training and support to help specialists stay current and manage their workload effectively.

What is the difference between Medical Pre Authorization vs Medical Billing Specialist?

AspectMedical Pre AuthorizationMedical Billing Specialist
Required CredentialsOften requires knowledge of insurance policies and medical documentationRequires coding certifications and billing knowledge
Work EnvironmentHealthcare facilities, insurance companies, or third-party administratorsMedical offices, hospitals, or billing companies
Industry UsageUsed to approve procedures before treatmentHandles billing and claims processing after services

Medical Pre Authorization focuses on obtaining approval for procedures before they are performed, ensuring coverage. Medical Billing Specialists process claims and handle payments after services. Both roles are essential in healthcare but serve different stages of patient care and billing processes.

How do I become a medical pre authorization specialist?

To become a medical pre-authorization specialist, typically one needs a high school diploma or equivalent, along with knowledge of medical billing, coding, and insurance processes. Relevant skills include attention to detail, communication, and familiarity with healthcare management software; certifications such as Certified Medical Administrative Specialist (CMAS) can enhance job prospects.
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What states have the most Medical Pre Authorization jobs?

States with the most job openings for Medical Pre Authorization jobs include:

What job categories do people searching Medical Pre Authorization jobs look for?

The top searched job categories for Medical Pre Authorization jobs are:

Medical PRE Authorization jobs near you
Infographic showing various Medical Pre Authorization job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 15% Part Time, and 7% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $41,194 per year, or $19.8 per hour.

FQHC Pre-Authorization Specialist

AtlantiCare

Egg Harbor Township, NJ • On-site

$17.75 - $23.50/hr

Other

Posted 8 days ago

AtlantiCare rating

7.2

Company rating: 7.2 out of 10

Based on 109 frontline employees who took The Breakroom Quiz

345th of 893 rated healthcare providers

Job description

Job Description

Pre-authorization Specialist is responsible for the patient registration process, infusion center admissions, co-pay cash collection, and financial arrangement issues. This position verifies third party payer accounts, pre-authorization and/or pre-certification requirements. In addition, this position will be responsible for interfacing with all private payers or their designees to obtain authorization for treatments and or imaging/lab studies and will facilitate physician to physician peer reviews of questionable cases. This position assures assignment of appropriate codes and Diagnosis Related Group (DRG) codes, collects quality statistical information, and assures timely follow up and processing of all accounts. Finally, this position will perform charge data reconciliation of all infusion accounts. This position also collects data for statistical and/or financial analysis. This position will require ongoing communication and collaboration with the infusion team members and provides quality customer service. This position supports organizational goals by providing quality customer service, participating in performance improvement efforts and demonstrating a commitment to teamwork and cooperation.

Qualifications

Education: High school diploma or equivalent required. Ability to read, write, and speak English is required.

Experience: 1-3 years medical office experience required, healthcare preferably in a medical setting. Knowledge of medical or dental terminology preferred. Knowledge of general computer and data entry functions required.

Performance Expectations Demonstrates the competencies as established on the Assessment and Evaluation Tool for this position.

Work Environment Potential for exposure to the hazards and risk of the hospital environment, including exposure to infectious disease, hazardous substances, and potential injury. This position requires reaching, stooping, kneeling, and crouching approximately 25% of the workday. This position also requires frequently lifting, approximately 25-30 pounds, and occasional lifting of 50-100 pounds with assistance. The essential functions for this position are listed on the Assessment and Evaluation Tool.

Reporting Relationship This position reports to the Infusion Medical Director or designee.

What AtlantiCare employees say

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About AtlantiCare

Sourced by ZipRecruiter

AtlantiCare aims to deliver the highest quality of care combined with the best experience for our patients and their families. We believe you'll find that our culture of collaboration and care exemplifies the value we place on our patients, their families and our team members.

Industry

Hospitals

Company size

5,001 - 10,000 Employees

Headquarters location

Egg Harbor Township, NJ, US

Year founded

1993

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