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Prior Authorization Rep Jobs (NOW HIRING)

MDxHealth

Prior Authorization Specialist

Irvine, CA · On-site

$19.26 - $23/hr

Interacts with clients, insurance companies, patients, and sales representatives, as necessary, to request for prior authorizations. Responsible for documenting account activity, updating patient and ...

Medix

Prior Authorization Specialist

Phoenix, AZ · On-site

$18 - $21/hr

The actual posting represents a position at one of our clients. Job Summary Our client is seeking a dedicated Prior Authorization Specialist responsible for communicating with insurance providers to ...

Medix

Prior Authorization Specalist

Pittsburgh, PA · On-site

$22/hr

The actual posting represents a position at one of our clients. Job Summary Our client is seeking a Prior Authorization responsible for liaising with prescriber offices, utilizing technology for ...

Varite

$16.75 - $22.25/hr

The Rep I, Clinical Services takes in-bound calls from providers, pharmacies, members, etc ... Work closely with providers to process prior authorization (PA) and drug benefit exception requests ...

Mission Hospital

Authorization Representative

Largo, FL

$14.50 - $19.75/hr

Prior Authorization Specialist and Authorization Representative preferred Benefits HCA Florida Heart Institute, offers a total rewards package that supports the health, life, career and retirement of ...

US Tech Solutions

$17 - $19/hr

Prior Authorization Specialist takes in-bound calls from providers, pharmacies, members, etc ... The Rep I, Clinical Services will also assist with other duties as needed to include but not ...

Cinq Group

Prior Authorization Specialist

Altamonte Springs, FL · On-site

$16.75 - $22.50/hr

Coordinates appointment of representative document with patient and physician office. * Completes status check with insurance company regarding receipt of prior authorization and appeal and approval ...

Cinq Group

Prior Authorization Specialist

Altamonte Springs, FL · On-site

$16.75 - $22.50/hr

Coordinates appointment of representative document with patient and physician office. * Completes status check with insurance company regarding receipt of prior authorization and appeal and approval ...

Evolution Sports Group

$35 - $50/hr

Evolution Sports Group is a leading sports management company that represents top athletes in ... As a Prior Authorization Coordinator, you will be responsible for obtaining prior authorizations ...

Medix

Prior Authorization Specialist

Farmers Branch, TX · On-site

$20 - $24/hr

The actual posting represents a position at one of our clients. Job Summary Our client is seeking a Prior Authorization Specialist to join their team. The primary responsibilities include receiving ...

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$24.5K

$44.2K

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How much do prior authorization rep jobs pay per year?

As of Jun 4, 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 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.

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 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.

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.

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
Prior Authorization Specialist

Prior Authorization Specialist

MDxHealth

Irvine, CA • On-site

$19.26 - $23/hr

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 13 days ago

Job description

The Prior Authorization Specialist is responsible for all aspects of the prior authorization process. Responsibilities include collecting all the necessary documentation, contacting the client for additional information and completion of the required prior authorization in order to proceed with testing. Complete, timely, and accurate identification and submission of prior and retro authorization requests to the payors. Interacts with clients, insurance companies, patients, and sales representatives, as necessary, to request for prior authorizations. Responsible for documenting account activity, updating patient and claim information and demonstrates proficiencies with the XIFIN billing system to ensure all functionalities are utilized for the most efficient processing of claims and identifies prior authorization trends and/or issues resulting in delayed claims processing. Provides the highest level of customer service to internal and external clients.

  • Position is full time.
  • Shift is Monday to Friday, 6:00am to 2:30pm (Pacific Time)
  • Applicant must be able to work from home.
  • Minimum 2 years of customer service experience in the healthcare industry.
  • Proficiency in the XIFIN system is preferred.
  • Proficiency in the Glidian system is preferred.
  • High level of accuracy, attention to detail, ability to prioritize and meet defined deadlines is a must.
  • The ability to organize systematic paper and electronic files and the ability to work in a fast-paced team environment is desired.
  • Hiring range: $19.26 to $23.00. The actual rate will be determined based on experience and other factors permitted by law.

Mdxhealth seeks talented people who are passionate about improving the diagnosis and treatment of cancer patients.

Mdxhealth is a building world class healthcare company, providing significant career development and financial opportunities.

Company Benefits:

We offer a comprehensive compensation and benefits package, which includes a competitive salary, company paid medical, dental, vision and life insurance coverage, 401(k) with company match, generous employee discounts, a casual, but driven work environment, and the ability to make a real difference as a key contributor to our growth.

Mdxhealth is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.

Accessibility: If you need an accommodation as part of the employment process, please contact Human Resources at: 866-259-5644.