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Prior Auth Jobs (NOW HIRING)

Northern Light Health

Med Refill Prior Auth Spec I

Brewer, ME · On-site +1

$17.75 - $21.50/hr

Pharmacy - Refill-Auth Program Position is located: Cianchette Professional Blding Work Type ... The Medication Refill and Prior Authorization Specialist is an essential member of the Northern ...

University of Rochester

$19.62 - $26.49/hr

Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff ...

University of Rochester

$19.62 - $26.49/hr

Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff ...

University of Rochester

Referral & Prior Auth Rep III

$19.62 - $26.49/hr

Responsibilities Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non ...

University of Rochester

$19.62 - $26.49/hr

Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff ...

University of Rochester

Referral & Prior Auth Rep III

$19.62 - $26.49/hr

Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff ...

University of Rochester

Referral & Prior Auth Rep III

$19.62 - $26.49/hr

Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff ...

University of Rochester

Referral & Prior Auth Rep III

$19.62 - $26.49/hr

Oversees data and ensures compliance to enterprise standards and referral and prior authorization guidelines. Communicates regularly with patients, families, clinical and non-clinical staff ...

Cardinal Health

$16.75/hr

Prepare and submit complete prior auth packets via payer portals, third-party platforms, or fax (including DWO/CMN, prescriptions, clinical notes, and other required documentation). * Conduct phone ...

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How much do prior auth jobs pay per hour?

As of Jul 1, 2026, the average hourly pay for prior auth in the United States is $19.35, according to ZipRecruiter salary data. Most workers in this role earn between $15.87 and $21.15 per hour, depending on experience, location, and employer.

What career paths follow prior authorization?

A career in prior authorization typically leads to roles in healthcare administration, medical billing, and insurance coordination. Professionals in this field often advance to supervisory or managerial positions, or specialize in compliance and policy development, utilizing skills in healthcare regulations and documentation systems.

Is prior auth going away?

Prior authorization jobs involve reviewing insurance requests for medical procedures or medications. While some healthcare policies aim to streamline or reduce prior auth requirements, the process is still widely used and not expected to disappear entirely in the near future, making it a relevant role for those with attention to detail and knowledge of insurance protocols.

Is prior authorization a stressful job?

Prior authorization jobs can be stressful due to the need for accuracy, attention to detail, and managing tight deadlines to secure approvals for medical procedures or medications. The role often involves handling complex documentation, communicating with healthcare providers, and navigating insurance policies, which can contribute to workplace pressure. However, stress levels vary depending on the work environment and individual coping skills.

What is the difference between Prior Auth vs Medical Billing Specialist?

AspectPrior AuthMedical Billing Specialist
Required CredentialsKnowledge of insurance policies, certifications varyCertification often preferred, knowledge of billing codes
Work EnvironmentHealthcare offices, insurance companiesMedical offices, billing companies
Employer & Industry UsageUsed in healthcare to authorize proceduresUsed to process and submit medical claims
Common Search & ComparisonYesYes

Prior Auth involves obtaining approval from insurance companies before procedures, while Medical Billing Specialists handle the billing process after services are provided. Both roles are essential in healthcare administration but focus on different stages of patient care and reimbursement.

More about Prior Auth jobs
What cities are hiring for Prior Auth jobs? Cities with the most Prior Auth job openings:
What states have the most Prior Auth jobs? States with the most job openings for Prior Auth jobs include:
What job categories do people searching Prior Auth jobs look for? The top searched job categories for Prior Auth jobs are:
Prior Auth jobs near you
Infographic showing various Prior Auth job openings in the United States as of June 2026, with employment types broken down into 1% As Needed, 76% Full Time, 20% Part Time, 2% Contract, and 1% Nights. Highlights an 81% Physical, 3% Hybrid, and 16% Remote job distribution, with an average salary of $40,251 per year, or $19.4 per hour.
Med Refill Prior Auth Spec I

Med Refill Prior Auth Spec I

Northern Light Health

Brewer, ME • On-site, Remote

$17.75 - $21.50/hr

Full-time

Posted 6 days ago

Northern Light Health rating

6.5

Company rating: 6.5 out of 10

Based on 160 frontline employees who took The Breakroom Quiz

563rd of 877 rated healthcare providers

Job description

Northern Light Pharmacy
Department: Pharmacy - Refill-Auth Program
Position is located: Cianchette Professional Blding
Work Type: Full Time
Hours Per Week: 40.00
Work Schedule: 8:00 AM to 4:30 PM
Summary:
This is an entry level position. The Medication Refill and Prior Authorization Specialist is an essential member of the Northern Light Health team. The Specialist position supports a centralized service which assists with all aspects of the medication refill and prior authorization process including, utilizing the electronic medical record to process refills, processing prior authorizations, and providing call center support for the refill line for Northern Light Health practice patients across the State. Ideal candidates will have strong communication skills, ability to work independently and actively support patient-centered care with sensitivity and respect for all diversity of human experience. This is a remote, work from home, opportunity.
Responsibilities:
  • Under the supervision of the Lead Specialist, Program Manager and Director of Pharmacy the refill specialist will assist with all aspects of the medication refill process using established guidelines to facilitate authorization of medication refills for clinic patients.
  • Effectively receive prescription refills request via fax, e-prescription or phone and process requests in a timely manner utilizing the electronic health record (EHR) and in accordance with protocol and all NLH Policies and procedures.
  • Complete prior authorizations via third party applications and communicate to practice staff in an efficient and timely manner.
  • Demonstrate flexibility and teamwork by accepting changes to daily work assignments based on coverage needs and volume.
  • Escalates requests to prescriber and/or office staff when request requires extensive clinical review or denial.
  • Coordinate scheduling of visits and labs as directed by protocol, provider or the pharmacist.
  • Appropriately triage phone calls and voicemails from pharmacies, patients and providers.
  • Troubleshoot patient and provider questions and concerns, referring to Manager as appropriate.
  • Provides high quality customer service to patients, family members and care team members.
  • Signs work from home agreement and adhere to NLH's work from home policy. Understands that work from home authorization may be revoked by the Manager if conduct or productivity standards are not met.
  • May be required to work in-person from a business worksite for additional in-person training sessions or "go-live" events at the discretion of the Manager.
  • Other Duties as assigned

Other Information:
Competencies and Skills
  • Demonstrates Adaptability: Learns quickly when facing a new problem or unfamiliar task; is flexible in their approach with changing priorities and ambiguity. Manages change effectively and does not give up during adversity. Capable of changing one's behavioral style and/or views in order to attain a goal. Absorbs new information readily and puts it into practice effectively.
  • Demonstrates Emotional Intelligence: Exhibits a high level of self-awareness, self-management, other awareness and relationship management. Conducts themselves in an empathic, appropriate way, with a sense of humor and stimulates a collaborative work environment. Is respectful of the attitudes, feelings, or circumstances of others and aware of the influence of their own behavior on them. Is aware of relevant social, political, system, and professional trends and developments and uses this information for the organization's benefit.
  • Effectively Communicates: Listens, speaks and writes appropriately, using clear language. Communication methods are fitting to the message(s), audience, and situation and follow-ups are regular and timely. Shows that important (non-) verbal information is absorbed and understood and asks further questions to clarify when necessary. Expresses ideas and views clearly to others and has ability to adjust use of language to the audiences' level.
  • Exercises Sound Judgment & Decision Making: Understands and processes complex information, which allows for appropriate and accountable conclusions. Does not react too quickly or slowly. Balances facts, goals, and potential approaches taking the appropriate criteria into account. Makes active decisions and commits oneself by communicating confidently and respectfully.
  • Serves Others: Strives to understand, meet and exceed the expectations and requirements of internal and external customers which may include the people and communities in our service areas. Develops and maintains relationships, alliances and coalitions within and outside the organization and leverages them in order to obtain information, support, and promote cooperation and collaboration.
  • Behaves with Integrity and Builds Trust: Acts consistently in line with the core values, commitments and rules of conduct. Leads by example and tells the truth. Does what they say they will, when and how they say they will, or communicates an alternate plan.
  • Cultivates Respect: Treats others fairly, embraces and values differences, and contributes to a culture of belonging, empowerment, and cooperation.
  • Fosters Accountability: Creates and participates in a work environment where people hold themselves and others accountable for processes, results and behaviors. Takes appropriate ownership not only of successes but also mistakes and works to correct them in a timely manner. Demonstrates understanding that we all work as a team and the quality and timeliness of work impacts everyone involved.
  • Practices Compassion: Exhibits genuine care for people and is available and ready to help; displays a deep awareness of and strong willingness to relieve the suffering of others.

Education
  • Required High School Diploma/General Educational Development (GED)

Working Conditions
Questions? Contact Talent Acquisition:
phone: 207-973-7100
email: talentacquisition@northernlight.org

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