ZipRecruiter

Log In

1

Medical Prior Authorization Jobs (NOW HIRING)

CareMed Specialty Pharmacy

$23 - $25/hr

Pharmacy Prior Authorization Specialist - CareMed Specialty Pharmacy Buffalo, NY | Full-Time | ... Medical; Dental; Vision * 401k with a match * Paid Time Off and Paid Holidays * Tuition ...

MC-Rx

Prior Authorization Coordinator

Miramar, FL · On-site

$21 - $23/hr

Manage the full lifecycle of prior authorization (PA) requests in support of manufacturer-sponsored ... Strong understanding of medical terminology, insurance plans and authorization. * Bilingual English ...

Midland Health

Prior Authorization Coordinator

Midland, TX · On-site

$18.25 - $22.50/hr

Prior Authorization Coordinator is responsible for verifying patient-eligibility, coordinating ... medical benefits Analyzing reports, tracking, and obtaining necessary authorizations for all ...

next page

Showing results 1-20

All JobsMedical Prior Authorization Jobs

Medical Prior Authorization information

See salary details

$12

$22

$55

How much do medical prior authorization jobs pay per hour?

As of Jul 23, 2026, the average hourly pay for medical prior authorization in the United States is $22.95, according to ZipRecruiter salary data. Most workers in this role earn between $17.55 and $24.28 per hour, depending on experience, location, and employer.

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.

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

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 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.
More about Medical Prior Authorization jobs
What cities are hiring for Medical Prior Authorization jobs? Cities with the most Medical Prior Authorization job openings:
What states have the most Medical Prior Authorization jobs? States with the most job openings for Medical Prior Authorization jobs include:
Medical Prior Authorization jobs near you
Infographic showing various Medical Prior Authorization job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 87% Full Time, 10% Part Time, and 2% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $47,733 per year, or $22.9 per hour.
Prior Authorization Specialist

Prior Authorization Specialist

Midwest Vision Partners

Stow, OH

$16.50 - $22/hr

Full-time

Medical, Dental, Life, Retirement, PTO

Posted 11 days ago

Midwest Vision Partners rating

4.6

Company rating: 4.6 out of 10

Based on 12 frontline employees who took The Breakroom Quiz

Job description

Description
Utilizing billing, clinical resources, and customer service skills to effectively and efficiently triage for prior authorization requirements as needed for coverage.  Performs day to day Insurance Verification and Prior Authorization activities to support the Revenue Cycle and to ensure reimbursement for services in a timely and accurate manner.
Schedule
Monday - Friday 8 am - 5 pm



Key Responsibilities
The identification of Duties and Responsibilities does not display an exhaustive list of all duties that may be assigned to this position, nor does it restrict the related work that may be assigned to this position.
What you will be working on:
  • Review insurance requirements to determine if prior authorization is required.
  • Utilizes resources to identify any testing that may require prior authorization.
  • Review chart documentation to ensure patients meets payers medical necessity policy guidelines.
  • Review requisition to determine billing information, including insurance carrier and complete/submit accurate documents as required.
  • Coordinate with client to obtain needed medical documentation.
  • Ability to accurately complete the necessary paperwork to submit prior authorization request to insurance via phone, website, software, or fax
  • Timely follow-up with insurance carriers on pending prior authorization requests
  • Timely notification of appropriate RCM department of prior authorization status
  • Maintains current knowledge of payer policies and requirements and acts as a resource to team members and patients.
  • Maintain HIPAA Compliance



Skills Knowledge and Expertise
What will make you awesome:
  • Ability to review patient chart to ensure completeness and accuracy of information.
  • To be well-organized with a strong attention to detail is essential.
  • Ability to work efficiency and effectively under tight deadlines and high work volume
  • Advance knowledge of medical billing and coding
  • Ability to assist consistently with patient and physician request and act as a resource regarding insurance and authorization requirements. 
  • Excellent problem-solving skills.

What you know:
  • Possess at least one year of experience in a clinical setting
  • Knowledge of medical billing and coding.
  • High school graduate or equivalent
  • Ability to work as a team member as well as independently.
  • Strong interpersonal and communication skills.

Benefits
  • Competitive wages
  • Robust benefit package including medical, dental, life and disability (short- and long-term) insurance
  • Generous paid time off (PTO) program
  • Seven (7) company paid holidays
  • 401(k) retirement plan with company match
  • An organization focused on People, Passion, Purpose and Progress
  • Inspirational culture

What Midwest Vision Partners employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom