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Prior Authorization Representative 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

$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 · 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 ...

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 ...

Veterans Sourcing Group

Be Seen First

Healthcare Prior Authorization Representative

Chicago, IL · Remote

$20.28/hr

Operations Representative II - Medicare Coverage Support Location: Remote - Work From Home Pay Rate ... Process prior authorizations, coverage determinations, medication-benefit exceptions, and appeals ...

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 Representative Jobs

Prior Authorization Representative information

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$24.5K

$44.2K

$77K

How much do prior authorization representative jobs pay per year?

As of Jul 24, 2026, the average yearly pay for prior authorization representative 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 reviews and processes requests for medical services or medications that require approval from insurance companies before treatment. They verify patient information, ensure documentation is complete, and communicate with healthcare providers and insurers to obtain necessary approvals, often using specialized software. This role helps ensure that patients receive authorized care while complying with insurance policies.

How much do precertification specialists make?

Precertification specialists, also known as prior authorization representatives, typically earn between $35,000 and $55,000 annually, depending on experience, location, and employer. They often require strong knowledge of insurance policies and medical billing systems, with some roles offering additional certifications to increase earning potential.

What are some common challenges faced by Prior Authorization Representatives, and how can they be managed?

Prior Authorization Representatives often encounter challenges such as navigating complex insurance policies, managing high volumes of requests, and dealing with time-sensitive cases. Staying up-to-date with payer requirements and utilizing electronic health record (EHR) systems can help streamline the process. Strong communication and organizational skills are essential for collaborating with healthcare providers and insurance companies to ensure timely approvals and minimize delays for patients.

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

AspectPrior Authorization RepresentativeMedical Billing Specialist
CredentialsHigh school diploma; certification often preferredHigh school diploma; certification optional
Work EnvironmentHealthcare offices, insurance companiesMedical offices, billing companies
Primary ResponsibilitiesSecuring insurance approvals for proceduresProcessing and submitting medical claims

The Prior Authorization Representative focuses on obtaining insurance approvals before procedures, while the Medical Billing Specialist handles billing and claims processing after services are rendered. Both roles require knowledge of insurance policies and healthcare documentation, but they differ in their primary functions within the healthcare revenue cycle.

What does a Prior Authorization Representative do?

A Prior Authorization Representative is responsible for reviewing and processing requests for prior authorization of medical procedures, medications, or services. They work with healthcare providers, insurance companies, and patients to ensure that the necessary documentation is submitted and meets the insurance requirements for approval. Their role helps facilitate timely access to medical care by verifying coverage and resolving any issues that may delay treatment. Excellent communication and organizational skills are important for this position.

Is prior authorization a stressful job?

Prior Authorization Representatives often work in fast-paced healthcare environments where accuracy and efficiency are important. The job can be stressful due to tight deadlines, high call volumes, and the need to interpret complex insurance policies, but experience and strong organizational skills can help manage the workload.

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

To thrive as a Prior Authorization Representative, you need a strong understanding of healthcare insurance processes, medical terminology, and prior authorization guidelines, usually supported by a high school diploma or equivalent. Familiarity with healthcare management software, electronic medical records (EMRs), and payer-specific authorization portals is typically required. Attention to detail, problem-solving abilities, and effective communication are standout soft skills for this role. These competencies are essential to ensure timely and accurate processing of authorizations, minimize claim denials, and support patient access to necessary care.

What jobs pay 4000 a week without a degree?

Prior Authorization Representatives typically do not earn $4,000 weekly; however, some high-paying roles in sales, real estate, or specialized trades can reach that level without a degree. These jobs often require strong communication skills, experience, or certifications and may involve commission or performance-based pay structures.
More about Prior Authorization Representative jobs
What cities are hiring for Prior Authorization Representative jobs? Cities with the most Prior Authorization Representative job openings:
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What job categories do people searching Prior Authorization Representative jobs look for? The top searched job categories for Prior Authorization Representative jobs are:
Prior Authorization Representative jobs near you
Infographic showing various Prior Authorization Representative 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 • On-site

$38K - $52K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 13 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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