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Medical Prior Authorization Jobs in Minnesota (NOW HIRING)

We are looking for a Prior Authorization Specialist to support front-end revenue cycle operations ... Confirm medical, pharmacy, and plan benefits while identifying patient out-of-pocket responsibility ...

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The Prior Authorization Coordinator manages specific processes within the patient order. This ... Previous medical device (outpatient DME), insurance, revenue cycle management, reimbursement, or ...

Job Summary Our client is seeking a skilled Prior Authorization Nurse to assist with medication ... Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 ...

Dedicated Authorization Specialist

Hibbing, MN ยท Hybrid

$17.75 - $23.50/hr

As a Dedicated Authorization Specialist, you will complete all insurance requirements in regard to prior authorization and medical necessity in a timely matter. Follow all policies and procedures to ...

Authorization Specialist

Saint Paul, MN ยท On-site

$18.25 - $24.25/hr

Knowledge, Skills, and Abilities: * 2 years previous healthcare experience which may include medical terminology, insurance eligibility, prior authorizations, but not limited to ICD/CPT coding ...

Precert and Authorization Rep

Rochester, MN ยท Hybrid

$40K - $55K/yr

This may include processing of pre-certification and prior authorization for workers compensation ... Locating and sending required documentation (e.g., medical records) as appropriate to resolve the ...

Precert and Authorization Rep

Rochester, MN ยท Hybrid

$39K - $53K/yr

This may include processing of pre-certification and prior authorization for workers compensation ... Locating and sending required documentation (e.g., medical records) as appropriate to resolve the ...

Precert and Authorization Rep

Rochester, MN ยท Hybrid

$39K - $53K/yr

Medical: Multiple plan options. * Dental: Delta Dental or reimbursement account for flexible ... This may include processing of pre-certification and prior authorization for workers compensation ...

Precert and Authorization Rep

Rochester, MN ยท On-site

$16.50 - $21.25/hr

This may include processing of pre-certification and prior authorization for workers compensation ... Locating and sending required documentation (e.g., medical records) as appropriate to resolve the ...

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Medical Prior Authorization information

See Minnesota salary details

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How much do medical prior authorization jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for medical prior authorization in Minnesota is $22.48, according to ZipRecruiter salary data. Most workers in this role earn between $17.16 and $23.80 per hour, depending on experience, location, and employer.

What is medical prior authorization?

Medical prior authorization is a process used by health insurance companies to determine if they will cover a prescribed procedure, service, or medication before it is provided. Providers must submit a request for approval, including supporting documentation, to the insurance company. This process helps ensure that the service is medically necessary and meets the insurer's coverage criteria. Obtaining prior authorization does not guarantee payment, but it is often required to avoid claim denials and delays in patient care.

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

To thrive as a Medical Prior Authorization Specialist, you need in-depth knowledge of insurance policies, medical terminology, and healthcare regulations, typically supported by experience in medical billing or healthcare administration. Proficiency in prior authorization software, electronic health record (EHR) systems, and understanding of payer portals is essential. Strong attention to detail, excellent communication, and organizational skills help you navigate complex approval processes and interact effectively with providers and insurers. These skills ensure timely and accurate authorization of medical services, reducing delays in patient care and minimizing claim denials.

What are some common challenges faced in a medical prior authorization role, and how are they typically addressed?

A common challenge in Medical Prior Authorization is managing high volumes of requests while ensuring timely and accurate approvals. Specialists often deal with complex insurance policies and must coordinate closely with healthcare providers and insurance companies to obtain necessary documentation. To address these challenges, most teams utilize specialized software and standardized workflows, and regular training is provided to stay updated on changing regulations. Strong communication and organizational skills are essential for navigating these complexities and ensuring patients receive prompt care.

What is the difference between Medical Prior Authorization vs Medical Claims Specialist?

AspectMedical Prior AuthorizationMedical Claims Specialist
Required credentialsOften requires healthcare or insurance-related certificationsTypically requires insurance or billing certifications
Work environmentHealthcare offices, insurance companies, or hospitalsInsurance companies, healthcare providers, or billing departments
Employer and industry usageUsed in healthcare and insurance to approve proceduresUsed in insurance to process and adjudicate claims
Common search and comparison intentUnderstanding approval process for treatmentsUnderstanding claims processing and reimbursement

Medical Prior Authorization involves obtaining approval from insurance before certain treatments or procedures, ensuring coverage. Medical Claims Specialists handle the processing and reimbursement of insurance claims after services are provided. While both roles work within healthcare insurance, prior authorization focuses on pre-approval, whereas claims specialists manage post-service billing and claims processing.

How do I become a medical prior authorization specialist?

To become a medical prior authorization specialist, candidates typically need a high school diploma or equivalent, along with knowledge of medical billing, insurance processes, and healthcare regulations. Relevant skills include attention to detail, communication, and familiarity with electronic health record (EHR) systems; certifications such as the Certified Medical Administrative Specialist (CMAS) can enhance job prospects.

What career paths follow medical prior authorization?

Medical prior authorization professionals often advance to roles such as healthcare compliance specialists, insurance claims analysts, or healthcare managers. They may also pursue certifications in healthcare administration or coding to expand their career opportunities within the healthcare and insurance industries.

What cities in Minnesota are hiring for Medical Prior Authorization jobs?

Cities in Minnesota with the most Medical Prior Authorization job openings:

Infographic showing various Medical Prior Authorization job openings in Minnesota as of August 2026, with employment types broken down into 86% Full Time, 12% Part Time, and 2% Contract. Highlights an 94% In-person, 2% Hybrid, and 4% Remote job distribution, with an average salary of $46,750 per year, or $22.5 per hour.

Prior Authorization Representative

Vitreoretinal Surgery PLLC

Edina, MN โ€ข Hybrid

Full-time

Medical, Dental, Vision, Life, PTO

Re-posted 25 days ago


Job description

Apply Here: https://secure.onehcm.com/ta/VRSPLLC.jobs?ShowJob=620913089&TrackId=ZipRecruiter

We are seeking a detail oriented and patient focused individual to work as a Prior Authorization Specialist at our Edina, MN business office (3 days in office / 2 days work from home).

If you have a passion for providing exceptional patient care, are highly personable, team-oriented, attuned to accuracy and fine detail, and would like to advance your career in the medical field, we would like to talk to you!

Responsibilities for a Prior Authorization Specialist include:

  • Coordinate prior authorization requests with insurance companies.
  • Use internal technology, reports and spreadsheets to determine if prior authorizations are necessary.
  • Request prior authorizations by website and phone.
  • Follow up on prior authorization requests.
  • Review approved prior authorizations and enters information into patient’s chart and account.
  • Review denied prior authorizations and appeals when appropriate.
  • Coordinate with clinic staff, physicians and co-workers to accomplish prior authorization process.

Required Skills, Abilities and Attributes for a Prior Authorization Specialist include:

  • Medical insurance experience
  • Empathy for patients
  • Solid understanding of medical terminology
  • High attention to detail
  • Strong computer experience (multi screens, heavy website navigation, speed and accuracy in moving from window to window, etc.)
  • 10 key by touch
  • 50 wpm typing
  • Experience with AllScripts software
  • Problem solving skills
  • Love to research and solve puzzles
  • Previous prior authorization experience
  • Willingness to have tough conversations with insurance companies
  • Strong organizational skills
  • One year experience with appeal submissions and/or medical billing and coding certificate strongly preferred
  • Ability to read and interpret EOBs
  • An overall understanding of appeals processes through completion
  • Efficient and highly accurate user of applicable information technology and health care management systems
  • Meticulous attention to detail and ability to complete the job with minimal errors
  • Ability to prioritize and manage time effectively
  • Knowledge of HIPAA guidelines
  • Excellent oral and written communication skills
  • Be an excellent team player who works cooperatively and respectfully with all doctors, supervisors, and co-workers.

We offer excellent compensation and benefits, to include:

  • Paid Holidays - 7 days per year
  • Personal Time Off (PTO) - 16 days per year
  • Health Insurance
  • Health Savings Account
  • Dental Insurance (100% company paid single coverage)
  • Flexible Spending Accounts
  • Basic and Supplemental Term Life Insurance (100% company paid single coverage)
  • Long Term Disability (free single coverage)
  • Long Term Care (100% company paid single coverage)
  • Short-Term Disability
  • Vision Insurance
  • Pet Insurance
  • Annual $250 uniform (scrubs and shoes) reimbursement

About Retina Consultants of Minnesota (RCM):

RCM has 9 Minnesota locations - St, Louis Park, Edina, Edina Specialty, Woodbury, Blaine, Duluth, Maplewood, Anoka, and Mankato.

Everything we do…. every decision we make…takes our Guiding Principles into consideration. Our guiding principles are:

  • We exist to serve our patients. We will provide the best available medical skills, technology, and service. We will be their advocates. We will care for our patients as if they were members of our family. We will treat our patients with respect, dignity, and kindness.
  • We are proud of our dedicated staff. We will strive to provide a rewarding career with opportunity for personal and professional growth. We will promote teamwork. We will provide a respectful and safe working environment.
  • We are humbled that other doctors entrust their patients to our care. We will be available when we are needed. We will promptly communicate the results of patient evaluation and treatment. We will respect the referring doctors’ relationships with their patients.
  • We recognize that we have a responsibility to our community. We will strive to be desire to perpetually “Learn and Grow”
  • Efficient and highly accurate user of applicable information technology and health care management systems
  • A good corporate citizen. We will function ethically. We will be prudent in our stewardship of healthcare resources.
  • Medical advances are critical to our patients. We will remain at the forefront in the search for new knowledge and treatments of retinal disease. We will participate in clinical research. We will share our knowledge with our patients and referring doctors, and with our retinal colleagues around the world.