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Medical Prior Authorization Jobs (NOW HIRING)

Grace Health

Prior Authorization Specialist

Battle Creek, MI · On-site

$16.25 - $21.50/hr

Medical, vision, dental, life, and disability insurance * 401K match * 8 paid holidays * Employee ... Educates patients and staff about the process of medication prior authorizations. * Processes ...

Grace Health

Prior Authorization Specialist

Battle Creek, MI · On-site

$17 - $22.75/hr

Medical, vision, dental, life, and disability insurance * 401K match * 8 paid holidays * Employee ... Educates patients and staff about the process of medication prior authorizations. * Processes ...

Equitas Health

Prior Authorization Specialist

Columbus, OH · On-site

$18.13 - $21.78/hr

Prior Authorization Specialist Established in 1984, Equitas Health is a regional not-for-profit ... Medical Assistant, Certified Pharmacy Technician or Registered Pharmacy Technician (must be ...

Grace Health

Prior Authorization Specialist

Battle Creek, MI · On-site

$17 - $22.75/hr

Medical, vision, dental, life, and disability insurance * 401K match * 8 paid holidays * Employee ... Educates patients and staff about the process of medication prior authorizations. * Processes ...

Grace Health

Prior Authorization Specialist

Battle Creek, MI · On-site

$17 - $22.75/hr

Medical, vision, dental, life, and disability insurance * 401K match * 8 paid holidays * Employee ... Educates patients and staff about the process of medication prior authorizations. * Processes ...

TriHealth

Prior Authorization Specialist

Cincinnati, 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 ...

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 ...

1840 & Company

$16.75 - $22.25/hr

Prior Authorization Specialist We are seeking a detail-oriented and experienced Prior Authorization Specialist to manage the full lifecycle of prior authorizations (PAs) for medical services. The ...

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How much do medical prior authorization jobs pay per hour?

As of Aug 15, 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.

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 into roles such as healthcare compliance specialists, insurance claims analysts, or healthcare administrators. They may also pursue certifications in healthcare management or coding to expand their career opportunities within the healthcare industry.

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?

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.

Are medical prior authorization jobs in high demand?

Medical prior authorization jobs are in steady demand due to the increasing need for healthcare cost management and insurance verification. These roles often require knowledge of medical billing, coding, and insurance policies, and employment opportunities are available in healthcare administration and insurance companies.
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, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $47,733 per year, or $22.9 per hour.

Prior Authorization Specialist

Grace Health

Battle Creek, MI • On-site

$16.25 - $21.50/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 19 days ago

Grace Health (Kentucky) rating

7.8

Company rating: 7.8 out of 10

Based on 10 frontline employees who took The Breakroom Quiz

Job description

Job Title

Grace Health is currently seeking an individual that will obtain prior authorizations for patients and assist with the managed care process.

We offer competitive wages based on experience and up to 3 weeks of PTO in the first year! Other perks include no nights or weekend work.

$1,000 Sign-on bonus ($500 after successful completion of your probationary period and $500 after 6 months).

Benefits

  • Medical, vision, dental, life, and disability insurance
  • 401K match
  • 8 paid holidays
  • Employee wellness program focusing on physical, mental, and financial wellness

Examples Of Duties: (This list may not be all inclusive.)

  1. Educates patients and staff about the process of medication prior authorizations.
  2. Processes medication prior authorization requests.
  3. Communicates with patients, Grace Health staff and other offices or health care agencies regarding medication prior authorization.
  4. Develops and maintains a tracking system for medication prior authorizations.
  5. Documents appropriate information in the medical record.
  6. Maintains current resources related to medication prior authorizations.
  7. May assist staff and patients with the managed care process.

Requirements:

1. High school Diploma or GED

2. Completion of Medical Terminology

3. Ambulatory and Pharmacy experience preferred

4. Certified Clinical Medical Assistant Preferred

GH26

What Grace Health (Kentucky) employees say

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