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Prior Authorization Coordinator Jobs in Reston, VA

VSI

Insurance Authorization Specialist

Reston, VA · On-site

$19 - $25.25/hr

Coordinates with workers' compensation case managers to streamline authorizations for care * Tracks and monitors prior authorization status throughout the insurance approval process. * Utilizes a ...

VSI

Insurance Authorization Specialist

Reston, VA · On-site

Coordinates with workers' compensation case managers to streamline authorizations for care * Tracks and monitors prior authorization status throughout the insurance approval process. * Utilizes a ...

Astera-OneOncology

Radiology Coordinator

Washington, DC · On-site

$22 - $26/hr

The Radiology Coordinator is responsible for performing all duties related to pre-certification ... Radiology prior authorization experience is preferred. Responsibilities * Submit radiology orders ...

ARM Consulting

Reimbursement Specialist

Fort Belvoir, VA · On-site

$21.75 - $30/hr

... prior authorization and appeal processes,identifyingpayer -related accessbarriers, coordinating with specialty pharmacy partners, andassistinghealthcare providers with reimbursement-related ...

ARM Consulting

Reimbursement Specialist

Fort Belvoir, VA · On-site

$21.75 - $30/hr

... prior authorization and appeal processes, identifying payer-related access barriers, coordinating with specialty pharmacy partners, and assisting healthcare providers with reimbursement-related ...

Better Morning Inc

Care Coordinator

Ashburn, VA · On-site

$22 - $25/hr

Care Coordinator with some prior medical office experience needed to greet clients, schedule appointments, answer phones, check insurance benefits via phone or online, obtain prior-authorizations ...

Better Morning, Inc.

Care Coordinator

Ashburn, VA

Care Coordinator with some prior medical office experience needed to greet clients, schedule appointments, answer phones, check insurance benefits via phone or online, obtain prior-authorizations ...

OrthoVirginia

Registration Coordinator

Arcola, VA · On-site

$19.46 - $29.19/hr

Verifying insurance eligibility, obtaining prior authorizations, and collecting copays and other patient payments. * Coordinating with providers, clinical staff, financial counselors, and billing ...

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Prior Authorization Coordinator information

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How much do prior authorization coordinator jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for prior authorization coordinator in Reston, VA is $22.18, according to ZipRecruiter salary data. Most workers in this role earn between $18.51 and $23.03 per hour, depending on experience, location, and employer.

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

AspectPrior Authorization CoordinatorMedical Billing Specialist
CredentialsTypically requires knowledge of insurance policies, healthcare regulations, and sometimes certifications like CPC or CPC-HRequires coding certifications (CPC, CCS) and knowledge of billing procedures
Work EnvironmentHealthcare facilities, insurance companies, or billing companiesMedical offices, hospitals, or billing companies
Employer & Industry UsageUsed in healthcare settings to manage insurance approvalsUsed across healthcare to process and submit claims
Search & Comparison IntentPeople compare roles related to insurance approval processesPeople compare roles related to billing and claims processing

The Prior Authorization Coordinator focuses on obtaining insurance approvals before treatment, ensuring coverage compliance. In contrast, the Medical Billing Specialist handles submitting claims and processing payments after services are rendered. Both roles are essential in healthcare administration but differ in their primary functions and workflows.

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

To thrive as a Prior Authorization Coordinator, you need strong knowledge of medical terminology, insurance processes, and healthcare regulations, often supported by experience in medical billing or a related certification. Familiarity with electronic health records (EHR), insurance portals, and prior authorization management systems is typically required. Attention to detail, organizational skills, and effective communication are essential soft skills for efficiently handling authorization requests and collaborating with providers and insurers. These skills ensure timely approvals, minimize claim denials, and support smooth patient access to prescribed care.

What is a prior authorization coordinator?

Prior Authorization Coordinators are healthcare professionals responsible for managing and obtaining approval from insurance companies before certain medical services, procedures, or medications are provided to patients. Their main duties include reviewing patient information, communicating with healthcare providers and insurers, and ensuring all necessary documentation is submitted for timely authorization. They play a crucial role in reducing delays in care and helping patients navigate complex insurance requirements. Strong communication, attention to detail, and knowledge of insurance processes are essential skills for this role.

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

Prior Authorization Coordinators often encounter challenges such as navigating complex insurance requirements, keeping up with frequent policy changes, and managing high volumes of requests. To handle these effectively, coordinators need strong organizational skills, attention to detail, and the ability to communicate clearly with both healthcare providers and insurance representatives. Staying updated on payer guidelines and using electronic health record (EHR) systems efficiently can also streamline the process and reduce delays in patient care.
What are the most commonly searched types of Prior Authorization jobs in Reston, VA? The most popular types of Prior Authorization jobs in Reston, VA are:
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Prior Authorization Coordinator jobs near you
Infographic showing various Prior Authorization Coordinator job openings in Reston, VA as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 18% Part Time, 1% Temporary, and 3% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $46,128 per year, or $22.2 per hour.

Prior Authorization Pharmacist

Accede Solutions Inc.

Mclean, VA • On-site

$59.75 - $71.75/hr

Other

Re-posted 18 days ago

Job description

Prior Authorization (PA) Pharmacist

The Prior Authorization (PA) Pharmacist would facilitate efforts in the review of clinical documentation and the Preferred Drug list (PDL) to determine proper medication therapy. The PA pharmacist will work with internal and external stakeholders in evaluating and continually developing a strategy for Utilization Management.

Responsibilities:

  • Clinical evaluation of medication therapy using established clinical or PDL criteria, drug compendia, and appropriate methods that support the principles of high-quality evidence-based medicine
  • Peer to Peer discussions with medical providers to discuss Prior Authorization reviews.
  • Consultations/Interventions: work with staff in contacting prescribers needing consultation to provide clinical information on prescribing practices that have been identified as outliers. Reviews prior authorizations data and determine opportunities for interventions.
  • Intervention Refinements: Collaborates on the refinement of consultation scripting; solicits and utilizes input from those contacted toward scripting improvements.
  • Operations: Contributes to the success of the Clinical Call Centers and Prior Authorization department by assisting with the implementation and management of both written and verbal communications to members and physicians. Is available for consultation on pharmacy-related questions and issues for others within the organization.
  • Quality Improvement: Contributes to program improvements by using continuous quality improvement processes, by being proactive in identifying improvement opportunities and by contributing on-going consultation and collaboration with product leaders.
  • Medical/Clinical: Upholds clinical integrity of pharmaceutical solutions by staying up to date on medication information, contributing to the identification of pharmacy program best practices, collaborating with Medical Directors, Clinical Pharmacist, and Clinical Specialty Pharmacist to provide pharmacy expertise.
  • Drug Review: Provides clinical input during the weekly drug file updates, making recommendations on applying utilization controls
  • Other duties as assigned. Contributes creative solutions to improve operational efficiency and effectiveness of pharmacy team

Qualifications:

  • Experience in the coordination of and collaboration of work teams preferred.
  • Ability to perform clinical reviews using relevant compendia and clinical trial data.
  • Managed care pharmaceutical service experience a plus.
  • Strong research and implementation skills in practical settings.
  • Analytical skills which can translate into practical and pragmatic recommendations.
  • Strong team orientation with respect for all members.
  • People skills are essential that allow for the successful consultation and collaboration with internal and external stakeholders who do not directly report to this job.

Requirements:

  • PharmD or B.S. in Pharmacy with relevant Specialty background
  • Registered Pharmacist with respective State Licensure
  • 4 years' experience in clinical pharmacy
  • Strong verbal and written communications skills.
  • Highly skilled with Microsoft office products and ability to quickly learn proprietary systems.

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