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Prior Authorization Rep Jobs (NOW HIRING)

Arizona Priority Care

Prior Authorization Rep

Chandler, AZ · Hybrid

$39K - $54K/yr

The Prior Authorization Representative I is responsible for processing incoming requests including verifying eligibility and benefits and the data entry component of the prior authorization request.

HaysMed

Prior Authorization Representative

Hays, KS · On-site

$15.75 - $20/hr

A Hospital Prior Authorization Representative assesses patient medical records, prepares and submits authorization requests, and liaises with insurance companies to resolve issues. They also inform ...

HaysMed

Prior Authorization Representative

Hays, KS · On-site

$18 - $26/hr

A Hospital Prior Authorization Representative assesses patient medical records, prepares and submits authorization requests, and liaises with insurance companies to resolve issues. They also inform ...

HaysMed

Prior Authorization Representative

Hays, KS

$15.75 - $20/hr

A Hospital Prior Authorization Representative assesses patient medical records, prepares and submits authorization requests, and liaises with insurance companies to resolve issues. They also inform ...

Managed Staffing

Prior Authorization Representative

AL · Remote

$17.50 - $18.50/hr

Prior Authorization Technician Location: Fully Remote (Work from Home - Anywhere in the U.S.) Pay Rate: $17.90/hour (W2) Schedule: Monday-Friday, 8-hour shifts between 8:00 AM-8:00 PM CT Training ...

BJC HealthCare

Prior Authorization Rep

Saint Louis, MO · Hybrid

$15.50 - $19.75/hr

EPIC, Insurance background, and Prior Authorization experience Overview Preferred Qualifications ... The role represent BJC with the highest standard of customer service, compassion and perform all ...

St. Peter's Health

Prior Authorization Specialist

Helena, MT · On-site

$16.25 - $21.50/hr

Sufficient experience to demonstrate ability to accept responsibility as a Hospital and Clinic prior authorization representative. * Knowledge of anatomy and physiology, medical terminology and ...

Equitas Health

Prior Authorization Specialist

Columbus, OH · On-site

$18.13 - $21.78/hr

The Prior Authorization Specialist handles all prior authorizations, third party appeals, and ... representatives. * Ensure proper documentation is maintained in the EHR. * Work with clinical ...

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All JobsPrior Authorization Rep Jobs

Prior Authorization Rep information

See salary details

$24.5K

$44.2K

$77K

How much do prior authorization rep jobs pay per year?

As of Jul 21, 2026, the average yearly pay for prior authorization rep in the United States is $44,219.00, according to ZipRecruiter salary data. Most workers in this role earn between $37,500.00 and $43,000.00 per year, depending on experience, location, and employer.

How does a Prior Authorization Rep typically collaborate with healthcare providers and insurance companies to resolve authorization issues?

A Prior Authorization Rep serves as a key liaison between healthcare providers, patients, and insurance companies. They regularly communicate with physicians' offices to collect necessary clinical information, and then work closely with insurance representatives to ensure all documentation meets policy requirements. When issues or denials arise, Prior Authorization Reps must problem-solve quickly, often clarifying details or appealing insurance decisions. This collaborative process requires strong communication skills, attention to detail, and the ability to manage multiple cases simultaneously.

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

To thrive as a Prior Authorization Rep, you need knowledge of healthcare insurance processes, medical terminology, and a high school diploma or equivalent, with some employers preferring additional healthcare certifications. Familiarity with insurance portals, electronic medical record (EMR) systems, and claims management software is typically required. Attention to detail, strong organizational skills, and effective communication are essential soft skills for this role. These abilities enable accurate processing of authorizations, minimize delays for patient care, and ensure compliance with payer requirements.

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

AspectPrior Authorization RepMedical Billing Specialist
CredentialsHigh school diploma; certifications like NCICS or AHIMA preferredHigh school diploma; certifications like CPC or CCS beneficial
Work EnvironmentHealthcare offices, insurance companies, hospitalsMedical offices, billing companies, healthcare facilities
Primary ResponsibilitiesSecuring insurance approvals for procedures and treatmentsProcessing and submitting medical claims, coding, and billing

The Prior Authorization Rep focuses on obtaining insurance approvals before procedures, while the Medical Billing Specialist handles billing and claims processing after services are rendered. Both roles require healthcare knowledge and often work in similar environments, but their core tasks differ significantly.

What does a Prior Authorization Representative do?

A Prior Authorization Representative is responsible for obtaining approval from insurance companies before certain medical procedures, medications, or treatments are provided to patients. They review clinical information, communicate with healthcare providers, and submit necessary documentation to payers to ensure services are covered. Their work helps prevent unexpected costs for patients and ensures compliance with insurance requirements. This role requires strong communication, attention to detail, and knowledge of healthcare processes.
More about Prior Authorization Rep jobs
What states have the most Prior Authorization Rep jobs? States with the most job openings for Prior Authorization Rep jobs include:
What job categories do people searching Prior Authorization Rep jobs look for? The top searched job categories for Prior Authorization Rep jobs are:
Prior Authorization Rep jobs near you
Infographic showing various Prior Authorization Rep job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 87% Full Time, 10% Part Time, and 2% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $44,219 per year, or $21.3 per hour.
Prior Authorization Representative

Prior Authorization Representative

Clinical Associates, P.A.

Towson, MD

$38K - $52K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 days ago

Job description

Description

Prior Authorization Representative


At Clinical Associates, we make being healthy easier. As a premier multi-specialty physicians' practice located in the Towson, Pikesville, and Reisterstown communities, we connect our patients to a seamless system of integrated medical care. Our practice includes in-house specialists in areas of medicine, from cardiology to podiatry. We also offer unique services like our nuclear stress testing facility.


We are seeking to add an experienced and detail-oriented Prior Authorization Representative to our Cardiology team! Our ideal candidate will possess 1-2 years of experience in a healthcare setting with solid working knowledge of insurance verification & eligibility along with obtaining prior authorizations for office procedures and diagnostic testing. The candidate must be a team player and provide excellent customer service to our patients.


Shift Hours: Full Time / Monday - Friday 8:30 am - 4:30 pm

Location: Towson - 515 Fairmount Avenue or Pikesville - 1838 Greene Tree Road


**This is an in-person onsite position. No hybrid or remote work options are available.**


Job Duties include but are not limited to the following:

  • Runs appointment lists and verifies insurance coverage along with identifying which patients need prior authorizations for scheduled appointments, procedures, and diagnostic testing.
  • Completes the prior authorization process 2 weeks prior to the scheduled appointments.
  • Contacts patients to inform them of their financial out-of-pocket costs: co-pay, deductible, and co-insurance amounts.
  • Confirms if referrals have been received prior to scheduled appointments.
  • Contacts primary care providers or other healthcare facilities as needed to obtain referrals or missing information for office visits or procedures.
  • Contacts insurance companies to confirm continued coverage or to resolve billing issues, discrepancies, or denials.
  • Accurately enters and updates patient demographics, insurance information, and authorization and referral tracking into the EMR system.
  • Schedules appointments
  • Other duties as assigned to support the overall workflow efficiency of the department.

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MINIMUM QUALIFICATIONS:

  • High School Diploma or equivalent
  • Medical office or health care experience is required. Specialty medicine and/or Cardiology are a plus.
  • 1-2 years of proven experience in healthcare insurance verification / prior authorization or billing is required.
  • Strong attention to detail and organizational skills.
  • Strong time management skills.
  • Knowledge and understanding of CPT/ICD 10 coding and billing protocols.
  • Experience with EPM/EMR - specifically NextGen is a plus.
  • Excellent verbal communication skills with ability to hear and to speak standard English clearly and concisely.
  • Excellent written communication skills with ability to read, write and spell standard English clearly and concisely.
  • Ability to interact effectively with culturally diverse patients, practitioners, and employee population.
  • Ability to convey a positive attitude and project a professional image.
  • Ability to remain flexible and maintain confidentiality.
  • Possesses excellent time management skills.
  • Requires lengthy periods of sitting, intermittent standing, reaching, and bending.

Benefits:

  • Paid Time Off
  • Medical
  • Vision
  • Dental
  • Life Insurance
  • Paid Holidays
  • 401K(matching)

Clinical Associates is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

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