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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.

BJC HealthCare

Prior Authorization Rep

Saint Louis, MO · On-site

$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 ...

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 ...

Ascension

Prior Authorization Representative

Nashville, TN · On-site +1

$21.31 - $28.84/hr

What additional requirements you'll need * 2+ years of surgical prior authorization experience Life at Ascension: Where purpose meets opportunity Ascension is a leading nonprofit Catholic health ...

Medix

Prior Authorization Representative

New York, NY · On-site

$22 - $28/hr

* Submit and track Medicare prior authorization requests through Noridian and CGS payer portals. * Monitor authorization statuses and perform timely follow-up on pending or additional documentation ...

BJC

Prior Authorization Rep

Saint Louis, MO · On-site

$38K - $53K/yr

... authorization and NOA. Without the above we are limited in our collection of payment. The role represent BJC with the highest standard of customer service, compassion and perform all duties in a ...

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Prior Authorization Rep information

See salary details

$24.5K

$44.2K

$77K

How much do prior authorization rep jobs pay per year?

As of Sep 1, 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.

What does a prior authorization rep 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.

What skills and qualifications are needed to be a prior authorization rep?

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.

How does a prior authorization rep 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 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.

Are prior authorization jobs in high demand?

Prior authorization representative roles are in steady demand due to the increasing need for healthcare cost management and insurance verification. Employers in healthcare and insurance companies often seek candidates with strong attention to detail and familiarity with medical billing systems. Job growth is supported by ongoing healthcare industry expansion and regulatory changes requiring prior authorization 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 August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 18% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $44,219 per year, or $21.3 per hour.

Prior Authorization Representative

Vitreoretinal Surgery PLLC

Edina, MN • Hybrid

$18.75 - $25/hr

Full-time

Medical, Dental, Vision, Life, PTO

Re-posted 23 days ago

Job description

Apply Here: https://secure.onehcm.com/ta/VRSPLLC.jobs?ShowJob=620913089&TrackId=ZipRecruiter

We are seeking a detail oriented and patient focused individual to work as a Prior Authorization Specialist at our Edina, MN business office (3 days in office / 2 days work from home).

If you have a passion for providing exceptional patient care, are highly personable, team-oriented, attuned to accuracy and fine detail, and would like to advance your career in the medical field, we would like to talk to you!

Responsibilities for a Prior Authorization Specialist include:

  • Coordinate prior authorization requests with insurance companies.
  • Use internal technology, reports and spreadsheets to determine if prior authorizations are necessary.
  • Request prior authorizations by website and phone.
  • Follow up on prior authorization requests.
  • Review approved prior authorizations and enters information into patient’s chart and account.
  • Review denied prior authorizations and appeals when appropriate.
  • Coordinate with clinic staff, physicians and co-workers to accomplish prior authorization process.

Required Skills, Abilities and Attributes for a Prior Authorization Specialist include:

  • Medical insurance experience
  • Empathy for patients
  • Solid understanding of medical terminology
  • High attention to detail
  • Strong computer experience (multi screens, heavy website navigation, speed and accuracy in moving from window to window, etc.)
  • 10 key by touch
  • 50 wpm typing
  • Experience with AllScripts software
  • Problem solving skills
  • Love to research and solve puzzles
  • Previous prior authorization experience
  • Willingness to have tough conversations with insurance companies
  • Strong organizational skills
  • One year experience with appeal submissions and/or medical billing and coding certificate strongly preferred
  • Ability to read and interpret EOBs
  • An overall understanding of appeals processes through completion
  • Efficient and highly accurate user of applicable information technology and health care management systems
  • Meticulous attention to detail and ability to complete the job with minimal errors
  • Ability to prioritize and manage time effectively
  • Knowledge of HIPAA guidelines
  • Excellent oral and written communication skills
  • Be an excellent team player who works cooperatively and respectfully with all doctors, supervisors, and co-workers.

We offer excellent compensation and benefits, to include:

  • Paid Holidays - 7 days per year
  • Personal Time Off (PTO) - 16 days per year
  • Health Insurance
  • Health Savings Account
  • Dental Insurance (100% company paid single coverage)
  • Flexible Spending Accounts
  • Basic and Supplemental Term Life Insurance (100% company paid single coverage)
  • Long Term Disability (free single coverage)
  • Long Term Care (100% company paid single coverage)
  • Short-Term Disability
  • Vision Insurance
  • Pet Insurance
  • Annual $250 uniform (scrubs and shoes) reimbursement

About Retina Consultants of Minnesota (RCM):

RCM has 9 Minnesota locations - St, Louis Park, Edina, Edina Specialty, Woodbury, Blaine, Duluth, Maplewood, Anoka, and Mankato.

Everything we do…. every decision we make…takes our Guiding Principles into consideration. Our guiding principles are:

  • We exist to serve our patients. We will provide the best available medical skills, technology, and service. We will be their advocates. We will care for our patients as if they were members of our family. We will treat our patients with respect, dignity, and kindness.
  • We are proud of our dedicated staff. We will strive to provide a rewarding career with opportunity for personal and professional growth. We will promote teamwork. We will provide a respectful and safe working environment.
  • We are humbled that other doctors entrust their patients to our care. We will be available when we are needed. We will promptly communicate the results of patient evaluation and treatment. We will respect the referring doctors’ relationships with their patients.
  • We recognize that we have a responsibility to our community. We will strive to be desire to perpetually “Learn and Grow”
  • Efficient and highly accurate user of applicable information technology and health care management systems
  • A good corporate citizen. We will function ethically. We will be prudent in our stewardship of healthcare resources.
  • Medical advances are critical to our patients. We will remain at the forefront in the search for new knowledge and treatments of retinal disease. We will participate in clinical research. We will share our knowledge with our patients and referring doctors, and with our retinal colleagues around the world.