Prior Authorization
$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 ...
$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 ...
$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 ...
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 ...
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 ...
Frisco, TX · On-site +1
$20 - $23/hr
Soleo Health is seeking a Prior Authorization Coordinator to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care! Specialty infusion prior ...
Quick apply
Frisco, TX · On-site +1
$20 - $23/hr
Soleo Health is seeking a Prior Authorization Coordinator to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care! Specialty infusion prior ...
$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 ...
$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 ...
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 ...
Quick apply
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 ...
Bowling Green, KY · On-site
$17.75 - $23.50/hr
The Prior Authorization Specialist is responsible for verifying patient eligibility and insurance benefits for clinic-administered medications. This position requires a thorough understanding of ...
Bowling Green, KY · On-site
$17.75 - $23.50/hr
The Prior Authorization Specialist is responsible for verifying patient eligibility and insurance benefits for clinic-administered medications. This position requires a thorough understanding of ...
Pittsburgh, PA · On-site
$17.50 - $23.25/hr
We have a great opportunity for an on-site Pharmacy Prior Authorization Specialist in Pittsburgh, PA Company Overview: We are the world's first pharma-to-patient cloud that offers a digital concierge ...
Pittsburgh, PA · On-site
$17.50 - $23.25/hr
We have a great opportunity for an on-site Pharmacy Prior Authorization Specialist in Pittsburgh, PA Company Overview: We are the world's first pharma-to-patient cloud that offers a digital concierge ...
New Orleans, LA · On-site
$17.25 - $23/hr
Louisiana Pain Specialists is looking for a Prior Authorization Specialist to join our pain management team in New Orleans. This full-time position is responsible for obtaining and managing prior ...
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New Orleans, LA · On-site
$17.25 - $23/hr
Louisiana Pain Specialists is looking for a Prior Authorization Specialist to join our pain management team in New Orleans. This full-time position is responsible for obtaining and managing prior ...
Pittsburgh, PA · On-site
$17.50 - $23.25/hr
We have a great opportunity for an on-site Pharmacy Prior Authorization Specialist in Pittsburgh, PA Company Overview: We are the world's first pharma-to-patient cloud that offers a digital concierge ...
Pittsburgh, PA · On-site
$17.50 - $23.25/hr
We have a great opportunity for an on-site Pharmacy Prior Authorization Specialist in Pittsburgh, PA Company Overview: We are the world's first pharma-to-patient cloud that offers a digital concierge ...
At The Remedy, the Prior Authorization Specialist plays an integral role in the patient intake and revenue cycle process. This role will focus on the coordination and management of medication and ...
New
At The Remedy, the Prior Authorization Specialist plays an integral role in the patient intake and revenue cycle process. This role will focus on the coordination and management of medication and ...
New
Pittsburgh, PA · On-site
$17.50 - $23.25/hr
We have a great opportunity for an on-site Pharmacy Prior Authorization Specialist in Pittsburgh, PA Company Overview: We are the world's first pharma-to-patient cloud that offers a digital concierge ...
New
Pittsburgh, PA · On-site
$17.50 - $23.25/hr
We have a great opportunity for an on-site Pharmacy Prior Authorization Specialist in Pittsburgh, PA Company Overview: We are the world's first pharma-to-patient cloud that offers a digital concierge ...
New
Frisco, TX · On-site
$20 - $23/hr
Soleo Health is seeking a Prior Authorization Coordinator to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care! Specialty infusion prior ...
Quick apply
Frisco, TX · On-site
$20 - $23/hr
Soleo Health is seeking a Prior Authorization Coordinator to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care! Specialty infusion prior ...
$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 ...
$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 ...
Position Title Prior Authorization Specialist / Prior Authorization Coordinator Department Prior Authorization Department Job Summary The Prior Authorization Specialist is responsible for obtaining ...
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Position Title Prior Authorization Specialist / Prior Authorization Coordinator Department Prior Authorization Department Job Summary The Prior Authorization Specialist is responsible for obtaining ...
The Prior Authorization Submitter (PAS) works directly with insurance companies to request a review for medical necessity and prior authorization for durable medical equipment before providing ...
The Prior Authorization Submitter (PAS) works directly with insurance companies to request a review for medical necessity and prior authorization for durable medical equipment before providing ...
Pittsburgh, PA · On-site
$17.50 - $23.25/hr
We have a great opportunity for an on-site Pharmacy Prior Authorization Specialist in Pittsburgh, PA Company Overview: We are the world's first pharma-to-patient cloud that offers a digital concierge ...
Pittsburgh, PA · On-site
$17.50 - $23.25/hr
We have a great opportunity for an on-site Pharmacy Prior Authorization Specialist in Pittsburgh, PA Company Overview: We are the world's first pharma-to-patient cloud that offers a digital concierge ...
$16.50 - $22/hr
Performs day to day Insurance Verification and Prior Authorization activities to support the Revenue Cycle and to ensure reimbursement for services in a timely and accurate manner. Schedule Monday ...
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$16.50 - $22/hr
Performs day to day Insurance Verification and Prior Authorization activities to support the Revenue Cycle and to ensure reimbursement for services in a timely and accurate manner. Schedule Monday ...
Waltham, MA · On-site +1
$23 - $28/hr
Pharmacy Prior Authorization Specialist - CareMed Specialty Pharmacy Waltham, MA | Full-Time | Starting at $23.00/hr and up Sign-On Bonus: $5,000 for employees starting before July 31, 2026. Join a ...
Waltham, MA · On-site +1
$23 - $28/hr
Pharmacy Prior Authorization Specialist - CareMed Specialty Pharmacy Waltham, MA | Full-Time | Starting at $23.00/hr and up Sign-On Bonus: $5,000 for employees starting before July 31, 2026. Join a ...
Coordinate prior authorization requests with insurance companies. * Use internal technology, reports and spreadsheets to determine if prior authorizations are necessary. * Request prior ...
Quick apply
Coordinate prior authorization requests with insurance companies. * Use internal technology, reports and spreadsheets to determine if prior authorizations are necessary. * Request prior ...
Position Title Prior Authorization Specialist / Prior Authorization Coordinator Department Prior Authorization Department Job Summary The Prior Authorization Specialist is responsible for obtaining ...
Quick apply
Position Title Prior Authorization Specialist / Prior Authorization Coordinator Department Prior Authorization Department Job Summary The Prior Authorization Specialist is responsible for obtaining ...
$13.70 - $15.38
6% of jobs
$15.38 - $17.07
14% of jobs
$17.49 is the 25th percentile. Wages below this are outliers.
$17.07 - $18.75
20% of jobs
The median wage is $19.69 / hr.
$18.75 - $20.43
18% of jobs
$20.43 - $22.12
16% of jobs
$22.31 is the 75th percentile. Wages above this are outliers.
$22.12 - $23.80
12% of jobs
$23.80 - $25.48
7% of jobs
$25.48 - $27.16
5% of jobs
$27.16 - $28.85
2% of jobs
$28.85 - $30.53
0% of jobs
$30.53 - $32.21
0% of jobs
$13
$20
$32
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.
| Aspect | Prior Authorization | Medical Billing Specialist |
|---|---|---|
| Credentials | Typically requires knowledge of insurance policies, healthcare regulations, and sometimes certifications like NCQA or AHIP | Requires knowledge of coding, billing procedures, and often certifications like CPC or CCS |
| Work Environment | Healthcare provider offices, insurance companies, or hospitals | Medical offices, billing companies, or healthcare facilities |
| Employer & Industry Usage | Used by healthcare providers and insurers to approve treatments or procedures | Used 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.

$16.75 - $22.50/hr
Other
Posted 11 days ago
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 role involves reviewing payer requirements, gathering appropriate clinical documentation, and communicating with insurance companies, pharmacies, and internal staff to facilitate authorization approvals. The ideal candidate demonstrates strong time management, attention to detail, integrity, and the ability to manage multiple requests while maintaining organization and professionalism in a high-volume environment.Â
Key ResponsibilitiesÂ
Complete authorization submissions through electronic platforms, payer portals, and telephone communications with insurance representatives when required.Â
Review patient charts to obtain relevant clinical documentation needed to support authorization requestsÂ
Communicate professionally with insurance companies, pharmacies, patients, and internal staff regarding authorization requirements and status updates.Â
Track and update prior authorization requests and outcomes using internal tracking tools and insurance portals to ensure timely processing and follow-up.Â
Demonstrate accountability for assigned authorization requests by monitoring status and following up with payers when necessary. Â
Actively monitor PA Pool and EHR inbox communications to ensure timely response to authorization requests and related inquiries.Â
Ensure all prior authorization submissions and supporting documentation accurately reflect the patient’s medical record and comply with payer requirements.Â
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; stoop, kneel, crouch, or crawl; and talk or hear. The employee must occasionally lift and/or move more than 45 pounds.
Familiarity with medical terminology and working knowledge of medical coding systems (CPT, ICD-10) relevant to prior authorization requests.Â
Strong organizational and time management skills, with the ability to prioritize urgent requests and meet deadlines in a high-volume environment.Â
Excellent written and verbal communication skills when interacting with patients, insurance representatives, pharmacies, and internal clinical staff.Â
Ability to work both independently and collaboratively within a team while managing multiple tasks simultaneously.Â
Demonstrates integrity, professionalism, and ethical decision-making when handling patient information and submitting prior authorization requests.Â
HS Diploma or GEDÂ required.Â
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Outpatient health care
51 - 200 Employees
Birmingham, AL, US
1940