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Prior Authorization Analyst Jobs (NOW HIRING)

PainPoint

Prior Authorization Coordinator

Atlanta, GA · On-site +1

$19 - $21/hr

Prior Authorization Coordinator Full-Time | $19-21/hour | Monday-Friday | 8:00 AM-4:30 PM CST ... Strong analytical and problem-solving abilities * Excellent organizational skills and attention to ...

Reliable Medical

Prior Authorization Specialist

Aurora, IL · On-site

$19.50 - $21.50/hr

Prior Authorization Specialist Since our doors opened in 1989, Reliable Medical has been committed ... Strong analytical skills for interpreting complex chart notes and billing codes. * Proactive and ...

ReliaMed

Prior Authorization Specialist

Aurora, IL · On-site

$19.50 - $21.50/hr

Prior Authorization Specialist Since our doors opened in 1989, Reliable Medical has been committed ... Strong analytical skills for interpreting complex chart notes and billing codes. * Proactive and ...

BCforward

Prior Authorization

Raleigh, NC

$17.50 - $23.25/hr

Provide functional and/or technical expertise to plan, analyze, define and support the delivery of future functional and technical capabilities for an application or group of applications. Assist in ...

Brownhealth

Prior Authorization Coord

Providence, RI

$19.03 - $31.39/hr

... obtaining prior authorization as necessary. Analyzes orders, authorizations and records ... Analytical skills to evaluate effectiveness of work flowwith the ability to make recommendations ...

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Prior Authorization Analyst information

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How much do prior authorization analyst jobs pay per year?

As of Jun 30, 2026, the average yearly pay for prior authorization analyst in the United States is $73,261.00, according to ZipRecruiter salary data. Most workers in this role earn between $52,500.00 and $87,000.00 per year, depending on experience, location, and employer.

What is the difference between Prior Authorization Analyst vs Claims Processor?

AspectPrior Authorization AnalystClaims Processor
Required CredentialsTypically requires healthcare-related certifications or knowledge, such as CPC or medical billing experienceOften requires basic billing or coding certifications, less specialized
Work EnvironmentHealthcare offices, insurance companies, or hospital settingsInsurance companies, healthcare providers, or billing departments
Employer & Industry UsageUsed in health insurance, hospitals, and healthcare organizationsCommon in insurance companies and healthcare billing departments
Search & Comparison IntentPeople compare to understand roles involving prior authorization and approvalsPeople compare to understand claims processing and reimbursement tasks

The Prior Authorization Analyst focuses on obtaining approvals for medical services before treatment, requiring specialized healthcare knowledge. In contrast, Claims Processors handle billing and reimbursement after services are provided. While both roles are essential in healthcare administration, they differ in responsibilities, credentials, and work environments.

What are some common challenges faced by Prior Authorization Analysts and how can they be effectively addressed?

Prior Authorization Analysts often face challenges such as managing high volumes of authorization requests, staying updated with frequently changing insurance policies, and ensuring timely communication between providers, patients, and payers. To address these challenges, it's important to stay organized, leverage technology tools for tracking requests, and participate in regular training sessions on policy updates. Building strong relationships with both clinical and administrative teams can also help streamline the authorization process and resolve issues quickly.

What are the key skills and qualifications needed to thrive as a Prior Authorization Analyst, and why are they important?

To thrive as a Prior Authorization Analyst, you need a solid understanding of medical terminology, insurance policies, and healthcare regulations, often supported by a healthcare-related degree or relevant experience. Familiarity with prior authorization software, electronic health record (EHR) systems, and payer portals is essential. Attention to detail, problem-solving abilities, and strong communication skills set top performers apart in this role. These competencies ensure timely and accurate processing of authorizations, reducing delays in patient care and maintaining compliance with payer requirements.

What does a Prior Authorization Analyst do?

A Prior Authorization Analyst is responsible for reviewing and processing requests for medical procedures, prescriptions, or services that require approval from insurance providers before they are carried out. They evaluate clinical documentation, verify eligibility, and ensure that requests meet the payer’s guidelines and criteria. Their work helps control healthcare costs and ensures patients receive appropriate care that is covered by their insurance plan.
More about Prior Authorization Analyst jobs
What are the most commonly searched types of Prior Authorization Analyst jobs? The most popular types of Prior Authorization Analyst jobs are:
What job categories do people searching Prior Authorization Analyst jobs look for? The top searched job categories for Prior Authorization Analyst jobs are:
Prior Authorization Analyst jobs near you

Prior Authorization Coord

Brown University Health

Providence, RI

$19.03 - $31.39/hr

Other

Posted 9 days ago

Key responsibilities

  • Registers patients prior to scheduled appointments to obtain updated account information for accurate insurance billing.

  • Confirms patient eligibility with insurance carriers and obtains pre-authorization requirements in accordance with established medical policies.

  • Coordinates and ensures appropriate insurance authorizations are obtained and communicates with providers to resolve billing issues and authorization denials.

Brown University Health rating

6.8

Company rating: 6.8 out of 10

Based on 70 frontline employees who took The Breakroom Quiz

483rd of 877 rated healthcare providers

Job description

SUMMARY Under supervision of the Manager Diagnostic Imaging Support Services, is responsible for the integrity of the pre-registration and prior authorization processes for outpatient radiological services within Brown University Health. Coordinates and arranges for all outpatient radiology orders to ensure patients have received financial clearance from insurance companies and troubleshoot as needed. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers, and one another.

In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate RESPONSIBILITIES PRINCIPAL DUTIES AND RESPONSIBILITIES: Registers patients prior to scheduled appointments to obtain updated account information for accurate insurance billing. Confirms patient eligibility with insurance carriers/third party payors and obtains pre-authorization requirements in accordance with established medical policies.

Coordinates and ensures appropriate insurance authorizations are obtained and/or received in a timely manner. Reviews, recognizes, and understands clinical documentation from patient records pertinent to obtaining prior authorization as necessary. Analyzes orders, authorizations, and records for discrepancies that may affect insurance coverage and/or denial of claims.

Notifies and coordinates with ordering physicians and providers when peer-to-peer discussions are required to obtain prior authorization of services being denied by patients' insurance. Professionally communicates with various Brown University Health personnel to resolve billing issues, authorization denials, and financial clearance of patient appointments. Provides mature, quality customer service to patients, their families, and/or their representatives.

Ensures all patients are financially cleared by insurance/third party payor prior to their scheduled appointments. Performs other duties as assigned. MINIMUM QUALIFICATIONS BASIC KNOWLEDGE: High school diploma or equivalent required.

Knowledge of business systems, office procedures, computer skills, medical terminology, and health insurance processes/terminology including, but not limited to, CPT and ICD-10 coding. Strong organizational skills, critical thinking, and focus to detail required to manage high volume of radiologic orders requiring prior authorization and/or financial clearance. Analytical skills to evaluate effectiveness of work flow with the ability to make recommendations, develop, and adapt to changes as necessary.

Interpersonal skills necessary to provide effective communication with patients and other healthcare professionals within and outside of Brown University Health. EXPERIENCE: Two years of previous experience in health care environment with emphasis in health insurance billing and reimbursement, healthcare operations, database management, and patient/provider interaction. WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS: Normal office environment; may experience some visual fatigue as a result of extended periods of work on the computer.

INDEPENDENT ACTION: Performs independently within the department's policies and practices. Refers specific complex problems to the supervisor when clarification of the departmental policies and procedures are required. SUPERVISORY RESPONSIBILITY: None.

Pay Range $19.03-$31.39 Location Rhode Island Hospital - 593 Eddy Street Providence, Rhode Island 02903 Work Type M-F 9:30am - 6:00 pm occasional weekends Work Shift Day Daily Hours 8 hours Driving Required No Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment. Apply

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