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Prior Authorization Analyst Jobs (NOW HIRING)

Leidos

Assessment & Authorization Analyst

Ashburn, VA · On-site

$69K - $125K/yr

... Authorization Analyst by evaluating CBP Information Systems being introduced to the environment to ... Prior experience with CBP * DoD 8570 IAT III * CompTIA Certified Advanced Security Practitioner ...

Leidos

Assessment & Authorization Analyst

Ashburn, VA · On-site

$69K - $125K/yr

... Authorization Analyst by evaluating CBP Information Systems being introduced to the environment to ... Prior experience with CBP * DoD 8570 IAT III * CompTIA Certified Advanced Security Practitioner ...

OPN Healthcare

Be Seen First

Prior Authorization & Referral Coordinator

Glendale, CA · On-site

$18 - $22/hr

Prior Authorization & Referral Coordinator Position Overview: OPN is seeking a highly organized and ... Analytical problem-solving capabilities to address administrative challenges efficiently. * Ability ...

W3R

PRIOR AUTHORIZATION THERAPIST

Austin, TX

Prior Authorization experience. * 1 year of customer service or call-center experience, preferred ... Proficient analysis and problem solving capabilities. * Proficient critical clinical thinking ...

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Prior Authorization Analyst information

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$73.3K

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How much do prior authorization analyst jobs pay per year?

As of Jul 21, 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
Infographic showing various Prior Authorization Analyst job openings in the United States as of July 2026, with employment types broken down into 1% Locum Tenens, 1% Internship, 86% Full Time, 6% Part Time, 1% Temporary, and 5% Contract. Highlights an 82% Physical, 5% Hybrid, and 13% Remote job distribution, with an average salary of $73,261 per year, or $35.2 per hour.

Medication Prior Authorization Specialist - Manning - Quality

El Rio Health

Tucson, AZ • On-site

$19.33 - $26.57/hr

Other

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

Job description

IntroductionAre you are looking for a career with one of Tucson’s largest, most highly regarded healthcare organizations that offers generous benefits, competitive salaries, free health classes and makes a difference in the lives of more than one in ten Tucsonans?

Overview

Salary: $19.33 - $26.57 Depending on experience

Schedule: Monday - Friday, 8:00am - 4:00pm

JOB PURPOSE: The Medication Prior Authorization Specialist is responsible for facilitating and processing medication prior authorizations to ensure timely patient access to prescribed therapies. This role operates within the Quality Department and is responsible for ensuring that all processes related to medication prior authorizations adhere to regulatory standards, quality control protocols, and best practices. The Medication Prior Authorization Specialist's main function is to complete prescription prior authorizations. The Medication Prior Authorization Specialist ensures patients receive medications that require pre-authorization from insurance carriers. Communicates with plans and pharmacy by analyzing insurance prior authorization requirements. It is the responsibility of the Medication Prior Authorization Specialist to receive, process and document all requirements, submit the required documentation, and update the Prior Authorization submission documents when necessary. They will collaborate with cross-functional teams to monitor, assess, and improve the quality of processes for prescription prior authorizations and medication services. This role requires a deep understanding of quality assurance principles, and strong analytical skills. In addition, the Specialist may be asked to perform other tasks in support of the Quality and Innovation team. The Medication Prior Authorization Specialist serves in a specialized administrative support role.

In this position, the defined duties and responsibilities for a Medication Prior Authorization Specialist will adhere to the regulations and the Policies and Procedures of El Rio Health. The Quality team works with periodic supervision and review, and any work problems involving departures from standard policies, interpretations, or procedures are reviewed with the supervisor for direction and resolution.

 

Responsibilities

  • Performs and/or completes all assigned duties, tasks, responsibilities, and assignments supporting the quality team with focus on Medication Prior Authorizations within established time frames; meeting established rates of performance for the quality and quantity of work for the position; demonstrating a high level of technical expertise, quality, efficiency, and accuracy in the employee’s job performance that ensures the highest standards of excellence.
  • Maintains proficient skill levels that meet defined performance expectations for a Medication Prior Authorization Specialist evidenced by successful demonstration of skills performance for this position upon evaluation.
  • Always maintains employee and/or patient confidentiality by controlling the environment and information being disclosed to authorized individuals ensuring compliance with all HIPAA and corporate compliance standards, as well as accepted human resources confidentiality standards.
  • Understands and complies with all organizational Code of Conduct standards, Policies and Procedures, and Service Excellence requirements with all patients, visitors, employees, and internal/external clients or representatives.
  • Always demonstrates a professional attitude and acceptable job performance for all duties, tasks, responsibilities, and assignments for this position at the assigned location and/or duty assignment that supports the operational needs of El Rio Health and as assigned by organizational leadership.
  • Possesses and demonstrates the knowledge, understanding, and specialized technical skills to complete all assigned duties, tasks, and responsibilities, in addition to working with the electronic health record.
  • Serves as an informational contact point for El Rio’s Quality & Innovation Team in relation to Medication Prior Authorizations supporting payors bringing any issues or requests to timely and effective resolution.
  • Collects, analyzes, and interprets quality-related data to identify trends and opportunities for enhancement.
  • Initiate authorization requests for Pharmacy in accordance with the prior authorization workflow.
  • Process faxes within established standards, follow up outbound calls with plans and pharmacies.
  • Gains and maintains a comprehensive understanding and proficient ability to ensure full compliance with all regulations, standards, or requirements for all Federal, State, and local laws; as well as all standards and requirements for internal/external grants or funding sources.
  • Demonstrates an exceptional level of customer service; answers and responds to all incoming calls, emails, and inquiries in a timely and effective manner, responds to requests and forwards any issues or complaints for resolution.
  • Maintains a clean, safe, and hygienic work environment in compliance with all Policies and Procedures including but not limited to work areas, workstations, examination rooms, hand washing, infection prevention and control etc. for this position.
  • Demonstrates an understanding of and proficiency with the application of all compliance and reporting requirements respective to Joint Commission Certification (JCC) standards.
  • Identifies and reports any safety hazard, or potential hazard, by immediately notifying supervisory staff and communicating the hazard in compliance with all Policies and Procedures; thereby ensuring that El Rio Health provides safe and clean facilities for all patients and visitors, as well as a safe and clean work environment for all employees.
  • Plans, organizes, and facilitates assigned events and projects that support the operations of the Quality and Innovation Department.
  • Demonstrates self-initiative by being aware of your work environment in order to assist co-workers and others while maintaining and enhancing a respectful and positive attitude in the work environment.
  • Always serves as a positive and effective role model/mentor to co-workers and other employees.
  • Participates in a learning environment by being willing to train, and learn with and from other employees, gaining new
  • skills and knowledge to enhance and improve the quality of service provided to employees, as well as all internal/external clients or representatives.

Requirements

  • High School Diploma or General Education Diploma (G.E.D).
  • Three (3) years experience working with insurance plans, Pharmacy benefits (PBM), and eligibility.
  • Two (2) years experience processing Medication Prior Authorizations, insurance verification and formularies.
  • Familiarity with EHR's EPIC
If applicable, equivalent combination of education and experience may be considered, and must be directly related to the functions and responsibilities of the job.
Required Licenses, Certifications, and Registrations:
  • Current certification in Basic Life Support (BLS) for health care providers.
  • Level I fingerprint clearance card: current valid and in good standing or have applied for it within seven working days after beginning employment.
  • Employees in this position are required to have reliable transportation that can meet any operational reassignments of the organization during the workday. If an employee is driving during work hours, the employee is required to possess a valid driver’s license and must comply with Arizona vehicle insurance requirements.
Preferred Education, Experience, Skills, Abilities:
  • Associate’s Degree in a Business or Finance related field from an accredited College or University.
  • A current License as a Pharmacy Technician in accordance with the Arizona State Board of Pharmacy requirements.
  • Two (2) years administrative experience, preferably in a healthcare environment.
  • Bilingual (English/Spanish) with the ability to speak, read and write in both languages.

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