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Prior Authorization Jobs (NOW HIRING)

Slocum

Prior Authorization

Eugene, OR · On-site

$18 - $24/hr

* Submits, tracks, and manages prior authorization requests for medical and ancillary procedures, within strict timeframes. * Researches and resolves authorization and referral claim denials, while ...

Urology Centers of Alabama

Prior Authorization

Birmingham, AL · On-site

$16.75 - $22.50/hr

General Summary The Prior Authorization Specialist coordinates and secures insurance authorization for medications, in-office injections, and imaging when needed to support timely patient care. This ...

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 ...

CareMed Specialty Pharmacy

$23 - $25/hr

Pharmacy Prior Authorization Specialist - CareMed Specialty Pharmacy Buffalo, NY | Full-Time | Starting at $23.00/hr and up Sign-On Bonus: $5,000 for employees starting before July 31, 2026. Join a ...

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 ...

MDxHealth

Prior Authorization Specialist

Irvine, CA · Remote

$19.26 - $23/hr

The Prior Authorization Specialist is responsible for all aspects of the prior authorization process. Responsibilities include collecting all the necessary documentation, contacting the client for ...

Aquent

Prior Authorization Specialist

Palo Alto, CA · On-site

$35.81 - $38.96/hr

Initiate, submit, and track medication prior authorizations and renewals within the Electronic Health Record (EHR) system and a dedicated prior authorization platform; meticulously document all ...

MC-Rx

Prior Authorization Coordinator

Miramar, FL · On-site

$21 - $23/hr

Manage the full lifecycle of prior authorization (PA) requests in support of manufacturer-sponsored patient support programs, utilizing payer portals, electronic submission platforms, fax, and ...

Curant Health

Prior Authorization Specialist

Smyrna, GA · On-site

$17.50 - $23.50/hr

The Prior Authorization specialist responsibilities includes: taking in-bound calls from providers, PBM, etc. providing phone assistance to all callers through the prior authorization process.

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How much do prior authorization jobs pay per hour?

As of Jun 6, 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 Is Prior Authorization?

Prior authorization is a check done by insurance companies and other third-party payers to determine whether or not they should pay for a medical procedure or specific medication. Factors that can trigger prior authorization requests include things like age, the availability of alternative medicines, or the need to check for drug interactions. If they reject the prior authorization, payers often require doctors to attempt the insurance company's preferred procedure and verify unsuccessful results before accepting an alternative treatment plan. Pre-authorization requests can take up to 30 days, though insurance companies and healthcare providers are continuing to work on ways to cut this time down.

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.

What is prior authorization in healthcare?

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.
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Prior Authorization jobs near you

Prior Authorization

Slocum

Eugene, OR • On-site

$18 - $24/hr

Other

Posted 26 days ago

Job description

  • Submits, tracks, and manages prior authorization requests for medical and ancillary procedures, within strict timeframes.
  • Researches and resolves authorization and referral claim denials, while coordinating with physicians, providers, and insurance payers to file appeals or facilitate a P2P.
  • Reviews patient medical records and clinical documentation to ensure they meet payer coverage criteria.
  • Collaborate with the RCM Prior Authorization Supervisor and Team Lead to develop and update authorization policies and procedures.
  • Maintain knowledge of payer guidelines (Medicare, Medicaid, Commercial, etc.) and ensuring regulatory compliance.
  • Partner with the RCM Prior Authorization Supervisor and Team Lead to analyze denied claims resulting from prior authorization and referral errors by identifying the root cause and provide the corrected data to the billing team for the purpose of appealing or resubmitting a corrected claim.
  • Interacts with insurance payers, physicians, providers, and Slocum departments to clarify coverage requirements to expedite approvals.
  • Work in collaboration with the RCM Prior Authorization Supervisor and Team Lead to monitor prior authorization related utilization trends, claim denials, denial rates, and provide performance improvement suggestions to senior leadership.
  • Communicate cross-functionally with providers and other Slocum departments regarding patient questions or referral and authorization concerns.
  • Perform other duties as assigned.

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