ZipRecruiter

Log In

1

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.

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 ...

next page

Showing results 1-20

All JobsEducation JobsHigher Education JobsAdmission Specialist JobsPrior Authorization Representative Jobs

Prior Authorization Representative information

See salary details

$24.5K

$44.2K

$77K

How much do prior authorization representative jobs pay per year?

As of Sep 5, 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 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.

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 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.

Are prior authorization representative jobs in high demand?

Prior Authorization Representative jobs are in steady demand due to the growing need for healthcare administrative support and insurance processing. These roles often require strong communication skills and familiarity with medical billing and coding systems, making them a stable career option in the healthcare industry.
More about Prior Authorization Representative jobs

What cities are hiring for Prior Authorization Representative jobs?

Cities with the most Prior Authorization Representative job openings:

What states have the most Prior Authorization Representative jobs?

States with the most job openings for Prior Authorization Representative jobs include:

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 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

Full-time

Medical, Dental, Vision, Life, PTO

Re-posted 26 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.