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Medical Prior Authorization Jobs (NOW HIRING)

IVX Health

Prior Authorization Coordinator

$19 - $23.50/hr

Manage Clinical Documentation - Obtain and assess necessary clinical information such as medical history, diagnosis, and lab reports to support Prior Authorization submissions. * Submit and Track ...

IVX Health

Prior Authorization Coordinator

$19 - $23.50/hr

Manage Clinical Documentation - Obtain and assess necessary clinical information such as medical history, diagnosis, and lab reports to support Prior Authorization submissions. * Submit and Track ...

Labcorp

Prior Authorization Specialist

$17.75 - $19.50/hr

Monitor prior authorization request status, track pending cases, and perform follow-up activities ... Review insurance policies, medical policies, and payer guidelines to ensure authorization requests ...

IVX Health

Prior Authorization Coordinator

Brentwood, TN · On-site +1

$17.50 - $21.75/hr

Manage Clinical Documentation - Obtain and assess necessary clinical information such as medical history, diagnosis, and lab reports to support Prior Authorization submissions. * Submit and Track ...

Labcorp

Prior Authorization Specialist

Burlington, NC · On-site

$15 - $20/hr

Monitor prior authorization request status, track pending cases, and perform follow-up activities ... Review insurance policies, medical policies, and payer guidelines to ensure authorization requests ...

OneOncology LLC

Prior Authorization Specialist

Huntsville, AL · On-site

$17.75 - $23.75/hr

Ability to navigate Health Plan websites for medical policy review regarding services. * Must be ... Prior Authorization experience preferred Working conditions This position works in the billing ...

Pure Infusion

Prior Authorization Specialist

Sandy, UT · On-site

$17 - $22.75/hr

Prior Authorization Specialist Behind every approved infusion treatment is a Prior Authorization ... This role requires a solid understanding of medical benefits, step therapy, and authorization ...

StatCare, LLC

Prior Authorization Coordinator

Knoxville, TN · On-site

$15.25 - $19/hr

Description StatCare is a private Pulmonary, Critical Care, Sleep, and Hospitalist medical practice ... Prior Authorization Coordinator is responsible for securing prior authorizations for diagnostic ...

OneOncology LLC

Prior Authorization Specialist

Huntsville, AL · On-site

$17.75 - $23.75/hr

Ability to navigate Health Plan websites for medical policy review regarding services. * Must be ... Prior Authorization experience preferred Working conditions This position works in the billing ...

OneOncology LLC

Prior Authorization Specialist

Huntsville, AL · On-site

$17.75 - $23.75/hr

Ability to navigate Health Plan websites for medical policy review regarding services. * Must be ... Prior Authorization experience preferred Working conditions This position works in the billing ...

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Medical Prior Authorization information

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$12

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$55

How much do medical prior authorization jobs pay per hour?

As of Sep 4, 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 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.
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 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 $47,733 per year, or $22.9 per hour.

Prior Authorization Coordinator

IVX Health

Remote

$19 - $23.50/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 13 days ago

IVX Health rating

5.8

Company rating: 5.8 out of 10

Based on 7 frontline employees who took The Breakroom Quiz

Job description

Join IVX Health as a Prior Authorization Coordinator!
Join a team that's redefining infusion care and creating exceptional patient experiences.
Are you experienced in navigating the complexities of prior authorizations for biologics or oncology therapies? IVX Health is looking for a driven and detail-oriented Prior Authorization Coordinator to support our rapidly growing team. In this role, you'll have the opportunity to make a meaningful impact by facilitating the approval process for life-changing specialty treatments. Our HQ is based just outside of Nashville in Brentwood, TN, but we are seeking candidates nationwide with the option to work fully remote, hybrid, or in-office!
Location and Schedule at a Glance
  • Work Options: Fully Remote, Hybrid, or In-office (Brentwood, TN)
  • Schedule: Monday - Friday, standard business hours (no nights, weekends, or holidays)

What You Will Do
  • Review and Process Prior Authorizations - Thoroughly review Prior Authorization orders and ensure timely and accurate completion.
  • Manage Clinical Documentation - Obtain and assess necessary clinical information such as medical history, diagnosis, and lab reports to support Prior Authorization submissions.
  • Submit and Track Prior Authorizations - Follow criteria for medication approvals and accurately submit requests to insurance providers.
  • Resolve Authorization Issues - Investigate and resolve outstanding medical documentation concerns and assist in resolving denied claims.
  • Support Patients and Providers - Communicate effectively with patients, clinical staff, and insurance representatives regarding the Prior Authorization process.
  • Ensure Compliance and Process Improvement - Stay up to date with evolving payer policies and identify ways to enhance workflow efficiency.
  • Perform Additional Duties - Take on other responsibilities as assigned to support patient care and operational objectives.

What We Are Looking For
We are seeking ambitious, self-motivated, and reliable professionals who take ownership of their work and excel in both remote and office settings. Success in this role requires initiative, accountability, and a commitment to getting the job done.
If you thrive in a structured yet independent work environment, communicate effectively, and hold yourself accountable, you will excel here. We value high performers who are dependable, communicative, and committed to delivering results.
  • Prior Authorization Expertise is Essential - You must have hands-on experience with prior authorizations for biologics, oncology, or specialty therapies, along with a strong understanding of payer guidelines.
  • Exceptional Communication Skills - This role involves frequent interaction with clinical teams, insurance companies, and patients. You must be able to communicate clearly, professionally, and persistently follow up when needed.
  • Self-Motivated and Accountable - If you work remotely, you are expected to be present, engaged, and consistently perform at a high level without direct supervision.
  • Tech-Savvy and Detail-Oriented - Proficiency in Electronic Health Records (EHR) systems, payer portals, and Microsoft Office Suite is required.
  • High School Diploma or GED required.
  • Associate's degree in Medical Office Management, Medical Insurance, or Medical Coding is a plus.
  • Minimum of three (3) years of experience in hospital or clinical service access, physician office scheduling, or a similar role.
  • Certified Medical Assistant (CMA) is a plus.
  • Experience with prior authorizations for biologics, oncology, or specialty therapies preferred.

Why Join IVX Health
  • Make a Meaningful Impact - Play a critical role in securing approvals for life-changing specialty treatments that directly improve patients' lives.
  • Grow Your Career - IVX Health offers a clear career path for Prior Authorization Coordinators, with opportunities for promotion from Level 1 to Level 2 and Level 3 based on performance and expertise..
  • Be Part of a Supportive and High-Performing Team - Work alongside a motivated, goal-driven team that values accountability, integrity, and results while fostering a positive, patient-focused environment.
  • Support and Development - Gain access to continuing education, professional development resources, and mentorship opportunities to expand your expertise.
  • Work-Life Balance - Enjoy flexible work options (remote, hybrid, or in-office), paid time off, and a no nights, no weekends schedule so you can recharge and perform at your best.

Pay is based on factors such as market location, job-related knowledge, skills, and experience, and is benchmarked against similar organizations in our size and industry. It is not typical for an individual to be hired at or near the top of the posted range, as compensation decisions depend on the facts and circumstances of each case. In addition to cash pay, full-time regular employees are eligible for 401(k), health benefits, and other company-provided benefits.
Prior Authorization Coordinator Pay Range
$22-$24 USD
About IVX Health
IVX Health is a national provider of infusion and injection therapy for patients managing complex chronic conditions. Through a patient-centered approach focused on comfort, convenience, clinical excellence, and exceptional service, we're redefining the care experience and improving lives every day. As a growing healthcare organization, we're committed to supporting our employees with meaningful work, professional development opportunities, and a culture built on collaboration, innovation, and purpose.
Guided by Our Purpose
Mission: To improve the lives of those we care for by redefining the care experience.
Vision: To be the nation's preferred destination for pharmaceutical care of complex chronic conditions.
Values: Be Kind. Do What's Right. Never Settle. Make It Happen. Enjoy the Ride.
Benefits & Perks
Eligible employees may receive:
  • Medical, Dental, and Vision Coverage
  • Prescription Drug Coverage and Telemedicine Services
  • Health Savings Account (HSA), Health Reimbursement Arrangement (HRA), and Flexible Spending Options
  • 401(k) Retirement Plan with Company Match
  • Life, AD&D, and Disability Insurance
  • Accident, Critical Illness, and Hospital Indemnity Coverage
  • Fertility and Family Planning Support
  • Tuition Reimbursement and Certification Assistance
  • Continuing Education and Professional Development Resources
  • Employee Assistance Program and Wellness Support
  • Paid Time Off
  • Volunteer Time Off and Charitable Giving Match
  • Employee Referral Bonus Program

Benefits may vary based on employment status and eligibility.
EEO STATEMENT
IVX Health is proud to be an Equal Opportunity Employer. We are committed to creating an inclusive workplace where all employees are treated with respect and provided equal employment opportunities. Employment decisions are made based on business needs, job requirements, qualifications, merit, and applicable law.
IVX Health prohibits discrimination, harassment, and retaliation of any kind and is committed to providing reasonable accommodations to qualified individuals with disabilities and those with sincerely held religious beliefs.
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