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Medical Prior Authorization Jobs in Ohio (NOW HIRING)

Equitas Health

Prior Authorization Specialist

Columbus, OH · On-site

$18.13 - $21.78/hr

The Prior Authorization Specialist handles all prior authorizations, third party appeals, and pending third party payer issues across all Equitas Health medical centers. This individual will work ...

TriHealth

Prior Authorization Specialist

Montgomery, OH · On-site

$17.25 - $23/hr

High School Degree or Medical Assistant * Certified Pharmacy Technician or Certified Medical Assistant desired * Prior experience with medication Epic and/or prior authorizations desirable * 2-3 ...

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All JobsMedical Prior Authorization JobsMedical Prior Authorization Jobs in Ohio

Medical Prior Authorization information

See Ohio salary details

$11

$21

$52

How much do medical prior authorization jobs pay per hour?

As of Sep 5, 2026, the average hourly pay for medical prior authorization in Ohio is $21.82, according to ZipRecruiter salary data. Most workers in this role earn between $16.68 and $23.08 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 Ohio are hiring for Medical Prior Authorization jobs?

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

Medical Prior Authorization jobs near you
Infographic showing various Medical Prior Authorization job openings in Ohio as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 12% Part Time, and 6% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $45,380 per year, or $21.8 per hour.

Prior Authorization Specialist

Medical Service Company

Toledo, OH • On-site

$20 - $25.05/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 28 days ago

Medical Service Company rating

6.7

Company rating: 6.7 out of 10

Based on 11 frontline employees who took The Breakroom Quiz

Job description

At MSC, we are dedicated to enhancing patient comfort and quality of life with over 75 years of experience and accredited by the Accreditation Commission for Health Care (ACHC).
MSC is a 13 -Time recipient of the prestigious NorthCoast 99 Award as a Top Workplace to work!
MSC is a two-time recipient of the prestigious National HME Excellence Award for Best Home Medical Equipment company in the US.
In addition, MSC is very proud to announce its debut on the Inc. 5000 list in 2024, marking a significant milestone in our company's growth and success!
Join Our Team!
We are excited to announce that we are hiring for a full-time hybrid position. Work in our office location on Tuesdays, Wednesdays, and Thursdays, and enjoy the flexibility of remote work on other days. Benefits included!
Apply today to become a part of our dynamic team!
  • Competitive Pay
  • Advancement Opportunities
  • Medical, Dental & Vision Insurance
  • HSA Account w/Company Contribution
  • Pet Insurance
  • Company provided Life and AD&D insurance
  • Short-Term and Long-Term Disability
  • Tuition Reimbursement Program
  • Employee Assistance Program (EAP)
  • Employee Referral Bonus Program
  • Social Recognition Program
  • Employee Engagement Opportunities
  • CALM App
  • 401k (with a matching program) / Roth IRA
  • Company Discounts
  • Payactiv/On-Demand Pay
  • Paid vacation, Sick Days, YOU (Mental Health) Days and Holidays

General: As part of the PAR team, participates in monitoring and improving processes relative to the quality, appropriateness, and timeliness of the reimbursement information requirements of our order processing activities.
Responsibilities and Duties:
• Initiates renewal authorization requests with insurance companies and government payers.
• Monitors outstanding renewal authorization requests and initiates follow up of authorizations in a timely manner.
• Responsible for working all outstanding held revenue related to prior authorizations for insurances assigned.
• Handles all claim denials due to missing prior authorization for insurances assigned.
• Maintains accurate and complete records concerning billing activity.
• Manages phone calls related to prior authorizations.
• Training related to PAR processes
• Processes insurance changes when prior authorizations are needed.
• Communicates obstacles or challenges to PAR Supervisor/Manager that may lead to inaccurate or untimely resubmissions of claims.
• Serves as back up for prior authorization team tier 1.
• Other duties as assigned.
Qualifications:
Education: Graduate of an accredited high school or GED equivalence.
Experience/Knowledge/Skills/Physical Requirements:
• Minimum 3 years of revenue cycle experience in healthcare
• Ability to multi-task in a fast-paced environment
• Detail and team oriented
• Effective communication (verbal and written) and organizational skills
• Proven computer proficiency, the use of multiple applications simultaneously
• Previous experience in prior authorizations and insurance verification is required
• Knowledge of the HME/DME industry is preferred
Pay Range: $20.00 - $25.05 per hour

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