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Prior Auth Jobs (NOW HIRING)

Conflux Systems

*Pharmacy Tech I

Seattle, WA · On-site

$21.29/hr

The role will mainly focus on Production, with an opportunity to learn other roles such as patient outreach, intake, shipping, or prior auth. * This position takes in-coming calls from members ...

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Prior Auth information

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$12

$19

$29

How much do prior auth jobs pay per hour?

As of Sep 2, 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 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.

Are prior authorization jobs in high demand?

Prior authorization jobs are in steady demand due to the increasing complexity of healthcare billing and insurance requirements. These roles often require knowledge of medical policies and the use of authorization software, making skilled professionals valuable in healthcare administration. The demand is expected to grow as healthcare providers seek to streamline approval processes and reduce claim denials.

How do I become a prior authorization specialist?

To become a prior authorization specialist, candidates typically need a high school diploma or equivalent, along with experience in healthcare or insurance. Relevant skills include knowledge of medical billing, coding, and insurance policies, and certifications such as Certified Medical Administrative Assistant (CMAA) or Certified Coding Associate (CCA) can enhance job prospects. On-the-job training is common, and strong communication and organizational skills are essential for success in this role.

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 quickly. The role often involves handling complex insurance policies and communicating with healthcare providers, which can contribute to workload pressure. However, stress levels vary depending on the work environment and individual coping strategies.
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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?

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Prior Auth jobs near you
Infographic showing various Prior Auth job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 16% Part Time, 1% Temporary, and 2% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $40,251 per year, or $19.4 per hour.

Nurse Annotator (Prior Auth) Remote in | , |

Genoa Telepsychiatry

Remote

Other

Retirement

This job post has expired today. Applications are no longer accepted.

Job description

Registered Nurse Clinical Annotator

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

The Registered Nurse Clinical Annotator plays a critical role in supporting the development of artificial intelligence models designed to streamline and automate prior authorization processes in healthcare. This position leverages clinical expertise to interpret, annotate, and validate medical documentation, ensuring that AI systems are trained on accurate, contextually relevant, and policy-compliant data.

You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:
  • Review medical records and interpret clinical documentation with accuracy and clinical judgment
  • Apply guideline-based criteria to annotate, categorize, and label case data used for AI model training
  • Ensure annotations are clinically sound, consistent, and aligned with established utilization management (UM) guidelines
  • Contribute to the development of high quality training datasets that support safe and effective AI model performance
  • Identify gaps, ambiguities, or inconsistencies in documentation and escalate issues as needed
  • Participate in refinement and continuous improvement of annotation guidelines, clinical rules, and workflows
  • Collaborate with cross functional teams including data science, clinical operations, and product teams to ensure clinical accuracy and operational relevance of labeled data
  • Support testing, validation, and quality review activities for AI supported UM tools and workflows
  • Maintain detailed documentation of annotation decisions, rationales, and guideline interpretations
  • Uphold clinical, ethical, and regulatory standards in all aspects of data handling, patient information, and annotation workflows

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:
  • Active, unrestricted RN license
  • 3+ years of recent clinical experience in acute care, utilization management, or a related clinical specialty
  • Experience applying guideline based criteria (e.g., InterQual, MCG) in clinical review or UM workflows
  • Solid understanding of clinical documentation, medical terminology, and evidence-based practice
  • Familiarity with HIPAA requirements, data privacy standards, and safe handling of patient information
  • Proficiency with electronic medical records (EMR) and comfort navigating multiple clinical systems
  • Proven ability to interpret medical records and determine clinical appropriateness using structured criteria
  • Demonstrated experience performing payer-based clinical prior authorization reviews and medical necessity determinations for outpatient and inpatient procedures, advanced imaging, DME, specialty medications, infusion therapies, and other pre-service requests in accordance with health plan policy and evidence-based clinical criteria. Experience limited to provider-side authorizations, concurrent inpatient review, post-acute review, or discharge planning alone is not sufficient
  • Proven ability to work independently while maintaining productivity, quality, and adherence to annotation guidelines
Preferred Qualifications:
  • BSN
  • Experience collaborating with cross functional teams (clinical, data science, operations)
  • Experience with data labeling, clinical data annotation, or AI/ML workflows
  • Proven high level of accuracy, attention to detail, and commitment to consistent, high quality annotations
  • Proven solid analytical thinking, clinical reasoning, and ability to identify gaps or inconsistencies in documentation
  • Proven effective written communication skills, with the ability to clearly document annotation decisions and rationales
  • Proven curiosity and willingness to learn emerging technologies, AI supported workflows, and evolving guidelines
Values Based Competencies Employee
  • Integrity Value: Act Ethically
    • Comply with Applicable Laws, Regulations and Policies
    • Demonstrate Integrity
  • Compassion Value: Focus on Customers
    • Identify and Exceed Customer Expectations
    • Improve the Customer Experience
  • Relationships Value: Act as a Team Player
    • Collaborate with Others
    • Demonstrate Diversity Awareness
    • Learn and Develop
  • Relationships Value: Communicate Effectively
    • Influence Others
    • Listen Actively
    • Speak and Write Clearly
  • Innovation Value: Support Change and Innovation
    • Contribute Innovative Ideas
    • Work Effectively in a Changing Environment
  • Performance Value: Make Fact-Based Decisions
    • Apply Business Knowledge
    • Use Sound Judgement
  • Performance Value: Deliver Quality Results
    • Drive for Results
    • Manage Time Effectively
    • Produce High-Quality Work

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $29.00 - $52.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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