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Prior Authorization Associate Jobs in Troy, MI (NOW HIRING)

Integra Partners

Medical Coding Specialist

Troy, MI · On-site

$65K/yr

Prior Authorization Program Support • Develop, validate, and maintain Prior Authorization code ... required. • Associate's or Bachelor's degree in Health Information Management, Healthcare ...

Ottobock

VOB & Auth Coordinator

Rochester Hills, MI · On-site +1

$17 - $21.75/hr

Associate degree in a relevant field preferred. * 2 years of insurance verification and prior authorization experience, preferably with orthotics, prosthetics and/or durable medical equipment ...

Halsey & Associates Inc

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Medical Front Office Coordinator

Detroit, MI · On-site

$17.53 - $21/hr

Coordinate referrals, medical records requests, prior authorization paperwork, prescription refill messages, lab result communications, and Provider follow-up requests as directed. * Keep the ...

Halsey & Associates Inc

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Medical Front Office Coordinator

Detroit, MI · On-site

$17.53 - $21/hr

Coordinate referrals, medical records requests, prior authorization paperwork, prescription refill messages, lab result communications, and Provider follow-up requests as directed. * Keep the ...

RCX Sports

Fulfillment Associate

Keego Harbor, MI · On-site

$17 - $18/hr

You will assist the Fulfillment Manager with solving problems prior to shipping orders. A ... Applicants must be currently authorized to work in the United States on a full-time basis.

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Prior Authorization Associate information

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How much do prior authorization associate jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for prior authorization associate in Troy, MI is $18.02, according to ZipRecruiter salary data. Most workers in this role earn between $14.38 and $19.13 per hour, depending on experience, location, and employer.

What is a prior authorization associate?

Prior Authorization Associates are professionals who handle the process of obtaining approval from insurance companies before certain medical services, procedures, or medications are provided to patients. They review clinical documentation, communicate with healthcare providers and insurers, and ensure all necessary information is submitted for timely authorization. Their work helps reduce claim denials and ensures patients receive the care they need while adhering to insurance requirements.

What are the key skills and qualifications needed to thrive as a prior authorization associate?

To thrive as a Prior Authorization Associate, you need a strong understanding of medical terminology, insurance processes, and prior authorization requirements, often backed by a high school diploma or associate degree. Familiarity with healthcare management software, electronic health record (EHR) systems, and payer portals is typically required. Excellent attention to detail, organizational skills, and effective communication are essential soft skills for this role. These skills ensure timely and accurate processing of prior authorizations, minimizing delays in patient care and supporting efficient healthcare operations.

What are some common challenges faced by a prior authorization associate, and how can they be effectively managed?

Prior Authorization Associates often encounter challenges such as navigating complex insurance requirements, handling high volumes of authorization requests, and managing tight turnaround times. Staying organized, keeping up-to-date with payer policies, and using robust tracking systems can help manage these difficulties. Collaborating closely with clinical staff and insurance representatives is also essential for resolving issues quickly and ensuring approvals are processed efficiently. Developing strong communication and problem-solving skills is key to success in this role.

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

AspectPrior Authorization AssociateMedical Billing Specialist
CredentialsHigh school diploma or equivalent; certification in medical billing or coding often preferredHigh school diploma or equivalent; certification in medical billing or coding often preferred
Work EnvironmentHealthcare offices, insurance companies, hospitalsHealthcare offices, billing companies, hospitals
Primary ResponsibilitiesObtain prior authorizations from insurance for procedures and treatmentsProcess and submit medical claims, handle billing and payments

The main difference is that a Prior Authorization Associate focuses on securing insurance approvals before procedures, while a Medical Billing Specialist manages the billing process after services are rendered. Both roles require similar credentials and often work in healthcare settings, but their core functions differ in the patient care and revenue cycle process.

Is a prior authorization associate a stressful job?

A prior authorization associate's job can be stressful due to the need for accuracy, meeting deadlines, and managing complex insurance requirements. The role often involves handling high volumes of requests and communicating with healthcare providers and insurers, which can contribute to workplace pressure.

What are popular job titles related to Prior Authorization Associate jobs in Troy, MI?

For Prior Authorization Associate jobs in Troy, MI, the most frequently searched job titles are:

What job categories do people searching Prior Authorization Associate jobs in Troy, MI look for?

The top searched job categories for Prior Authorization Associate jobs in Troy, MI are:

What cities near Troy, MI are hiring for Prior Authorization Associate jobs?

Cities near Troy, MI with the most Prior Authorization Associate job openings:

Prior Authorization Associate jobs near you

Medical Coding Specialist

Integra Partners

Troy, MI • On-site

$65K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted yesterday

Job description

The Medical Coding Specialist provides coding expertise to support Utilization Management operations, health plan implementations, prior authorization program development, and clinical policy initiatives. This position is responsible for researching, analyzing, and interpreting HCPCS, CPT, and ICD-10 coding guidance to support accurate prior authorization requirements, coding resources, and client deliverables across Medicare, Medicaid, Commercial, and Marketplace lines of business.

The Medical Coding Specialist partners with clinical, operational, compliance, business development, and client teams to ensure coding recommendations are accurate, compliant, and operationally sound. Success in this role requires strong attention to detail, critical thinking, organization, and the ability to produce high quality work while managing multiple priorities.

JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES

The Medical Coding Specialist's responsibilities include, but are not limited to:

Coding Support

• Research, analyze, and interpret HCPCS Level II, CPT, ICD-10-CM, and related coding guidance.

• Review coding resources, CMS guidance, payer policies, and regulatory requirements to support coding decisions.

• Assist with determining prior authorization requirements and appropriate code categorization.

• Apply coding knowledge across Medicare, Medicaid, Commercial, and Marketplace products.

Prior Authorization Program Support

• Develop, validate, and maintain Prior Authorization code lists and coding reference materials.

• Support implementation of new health plans, benefit designs, and coding configurations.

• Review client specific coding requirements and ensure recommendations align with contractual and regulatory requirements.

• Identify opportunities to improve coding consistency and operational efficiency.

Quality Review

• Perform thorough self review of work prior to submission to ensure accuracy, completeness, and consistency.

• Validate coding deliverables for duplicate records, formatting, categorization, and completeness.

• Maintain accurate documentation supporting coding decisions and recommendations.

• Meet established quality standards and project deadlines.

Research and Problem Solving

• Research unfamiliar coding scenarios using available coding resources and regulatory guidance.

• Identify questions or areas requiring clarification early in the work process.

• Present questions with supporting research and a recommended approach when seeking guidance.

• Participate in discussion and resolution of coding issues with internal stakeholders.

Collaboration

• Serve as a coding resource for Medical Management and other internal departments.

• Partner with clinical, operational, provider relations, credentialing, compliance, and business development teams on coding related initiatives.

• Support client implementations, operational projects, and coding validation activities.

• Participate in internal and external meetings as needed.

Education and Continuous Improvement

• Maintain current knowledge of coding regulations, CMS guidance, and industry best practices.

• Assist with development of coding guidance documents, training materials, and internal reference tools.

• Participate in audits, quality improvement initiatives, and accreditation activities.

• Perform other duties as assigned.

EDUCATION:

• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), or equivalent coding certification required/accepted.

• High school diploma or equivalent required.

• Associate's or Bachelor's degree in Health Information Management, Healthcare Administration, or related field preferred.

EXPERIENCE:

• Minimum of 3 years of medical coding experience.

• Experience with HCPCS, CPT, and ICD-10 coding required.

• Experience supporting health plans, utilization management, prior authorization, DMEPOS, or payer operations preferred.

• Knowledge of Medicare, Medicaid, and Commercial coding methodologies preferred.

• Experience reviewing CMS guidance, payer policies

SALARY: $65,000/Annually

Benefits Offered

  • Competitive compensation and annual bonus program

  • 401(k) retirement program with company match

  • Company-paid life insurance

  • Company-paid short term disability coverage (location restrictions may apply)

  • Medical, Vision, and Dental benefits

  • Paid Time Off (PTO)

  • Paid Parental Leave

  • Sick Time

  • Paid company holidays and floating holidays

  • Quarterly company-sponsored events

  • Health and wellness programs

  • Career development opportunities

Remote Opportunities

We are actively seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington.

Our Story

Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits.

With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We’re looking for energetic, talented, and dedicated individuals to join our team. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare. We look forward to learning more about you.

Integra Partners is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out. We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.

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