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Prior Authorization Jobs (NOW HIRING)

Franciscan Alliance

Prior Authorization Specialist

Munster, IN · On-site

$17.50 - $23.50/hr

Prior Authorization Specialist The Prior Authorization Specialist is responsible for obtaining prior authorization for provider practices, which may include outpatient services, specialty care and ...

Grace Health

Prior Authorization Specialist

Battle Creek, MI · On-site

$16.25 - $21.50/hr

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 ...

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 community-based healthcare system and federally qualified community health center look-alike. Its ...

Grace Health

Prior Authorization Specialist

Battle Creek, MI · On-site

$17 - $22.75/hr

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 ...

Grace Health

Prior Authorization Specialist

Battle Creek, MI · On-site

$17 - $22.75/hr

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 ...

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 ...

Oxford Solutions

Prior Authorization Specialist

Pittsburgh, PA · On-site

$16.75 - $22.50/hr

Days & Evenings (EST) Pay Rate: 18-20+/hr (depending on experience level) Oxford Solutions is seeking a Pharmacy Prior Authorization Specialist to join a growing pharmacy support team in Pittsburgh.

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How much do prior authorization jobs pay per hour?

As of Aug 9, 2026, the average hourly pay for prior authorization in the United States is $20.89, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $23.08 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a prior authorization specialist, and why are they important?

To thrive as a Prior Authorization Specialist, you need strong knowledge of medical terminology, insurance processes, and healthcare regulations, typically supported by a high school diploma or associate degree in a healthcare-related field. Familiarity with electronic medical records (EMR) systems, insurance portals, and authorization management software is essential. Attention to detail, effective communication, and problem-solving abilities help you navigate complex cases and collaborate with providers and payers. These skills ensure accurate and timely processing of authorizations, minimizing delays in patient care and reducing administrative errors.

What are some common challenges faced by prior authorization specialists, and how can applicants prepare for them?

Prior Authorization specialists often encounter challenges such as navigating complex insurance policies, managing high volumes of requests, and communicating effectively with both healthcare providers and insurance representatives. To prepare for these challenges, applicants should develop strong organizational skills, attention to detail, and a good understanding of medical terminology and insurance guidelines. Familiarity with electronic health records (EHR) systems and the ability to multitask in a fast-paced environment are also valuable assets in this role.

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

AspectPrior AuthorizationMedical Billing Specialist
CredentialsTypically requires knowledge of insurance policies, healthcare regulations, and sometimes certifications like NCQA or AHIPRequires knowledge of coding, billing procedures, and often certifications like CPC or CCS
Work EnvironmentHealthcare provider offices, insurance companies, or hospitalsMedical offices, billing companies, or healthcare facilities
Employer & Industry UsageUsed by healthcare providers and insurers to approve treatments or proceduresUsed by healthcare providers and billing companies to process claims and payments

While both roles are essential in healthcare administration, Prior Authorization focuses on obtaining approval for treatments, whereas Medical Billing Specialists handle the financial aspects of claims processing. Understanding their differences helps clarify their distinct responsibilities within the healthcare system.

How do I become a prior authorization specialist?

To become a prior authorization specialist, you typically need a high school diploma or equivalent and gain experience in healthcare or insurance billing. Relevant skills include knowledge of medical terminology, insurance policies, and proficiency with electronic health record (EHR) systems; certifications such as Certified Medical Administrative Assistant (CMAA) can also enhance job prospects.

What is a prior authorization job?

A prior authorization job involves reviewing and processing requests from healthcare providers to approve specific medical treatments, medications, or procedures before they are administered. The role requires knowledge of insurance policies, medical terminology, and attention to detail, often utilizing electronic health record systems. It is essential for ensuring that treatments meet insurance criteria and are covered under the patient's plan.

What are the career paths in prior authorization?

Careers in prior authorization typically include roles such as prior authorization specialists, medical reviewers, and healthcare administrators. Advancement can lead to supervisory or managerial positions, and professionals often develop skills in healthcare regulations, insurance policies, and medical coding. Certifications in medical billing and coding can enhance career growth in this field.

What is prior authorization?

Prior authorization is a process used by health insurance companies to determine if they will cover a prescribed procedure, service, or medication. Before the provider delivers the service, they must receive approval from the insurer. This process helps control costs and ensures that the service or medication is medically necessary. It often involves submitting documentation and waiting for a decision, which can sometimes delay patient care. Patients and providers should check with insurance companies to understand which services require prior authorization.
More about Prior Authorization jobs
What cities are hiring for Prior Authorization jobs? Cities with the most Prior Authorization job openings:
What are the most commonly searched types of Prior Authorization jobs? The most popular types of Prior Authorization jobs are:
What states have the most Prior Authorization jobs? States with the most job openings for Prior Authorization jobs include:
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Prior Authorization jobs near you
Infographic showing various Prior Authorization job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $43,459 per year, or $20.9 per hour.

Prior Authorization Specialist

Franciscan Alliance

Munster, IN • On-site

$17.50 - $23.50/hr

Other

Posted 5 days ago

Franciscan Health rating

6.8

Company rating: 6.8 out of 10

Based on 268 frontline employees who took The Breakroom Quiz

452nd of 887 rated healthcare providers

Job description

Prior Authorization Specialist

The Prior Authorization Specialist is responsible for obtaining prior authorization for provider practices, which may include outpatient services, specialty care and other ancillary services. The Prior Authorization Specialist verifies insurance coverage and gathers clinical information to ensure that all reimbursement requirements are met.

Who We Are

Franciscan Health is a leading healthcare organization dedicated to providing exceptional patient care and promoting health and wellness in our community. Our mission is to ensure that every patient receives the highest quality of care through innovation, compassion, and excellence. With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers who provide compassionate, comprehensive care for our patients and the communities we serve.

What You Can Expect
  • Flexible position, work from home 2 days, in person (Munster, IN) 3 days.
  • Monday through Friday 8:00am to 5:00pm.
  • Training will be 1 month on site (Munster, IN).
  • Serve as primary contact, educator, and resource for all ambulatory department prior authorization requirements and processes.
  • Collect clinical and coding information regarding services to be rendered.
  • Contact payer to obtain prior authorization.
  • Provide standardized documentation within EPIC to identify prior authorization and the criteria surrounding such authorization; stay informed and research information regarding insurance criteria for prior authorization.
  • Verify standard documentation and requirements have been met, and advise providers and their clinical staff when issues arise relating to obtaining prior authorization.
Qualifications
  • Required High School Diploma/GED
  • 1 year Prior Authorizations and Revenue Cycle Required

Travel is required: Never or Rarely

Equal Opportunity Employer

It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity.

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