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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.

Avera Health

Prior Authorization Representative

Le Mars, IA · On-site

$16 - $19.25/hr

Floyd Valley Healthcare in Le Mars, IA has a full-time Centralized Authorization Representative ... Appropriately document prior authorization and communicate information to performing facility ...

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 ...

BJC

Prior Authorization Rep

Saint Louis, MO · On-site

$16.50 - $21.25/hr

Prefer experience: EPIC, Insurance background, and Prior Authorization experience Overview ... 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 ...

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Prior Authorization Representative information

See salary details

$24.5K

$44.2K

$77K

How much do prior authorization representative jobs pay per year?

As of Aug 15, 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.

How to become a prior authorization representative?

To become a prior authorization representative, candidates typically need a high school diploma or equivalent and should develop skills in medical terminology, insurance policies, and data entry. Relevant experience in healthcare or insurance billing can be beneficial, and some employers may require familiarity with electronic health record (EHR) systems. Certification is not mandatory but can enhance job prospects and demonstrate expertise in healthcare administration.

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 jobs in high demand?

Prior authorization representative roles are in steady demand due to the increasing need for healthcare cost management and insurance verification. These jobs often require strong attention to detail and familiarity with healthcare systems and electronic health records. The demand is expected to grow as healthcare providers and insurers continue to streamline approval processes.

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.
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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 33% Full Time, and 67% Part Time. Highlights an 100% In-person job distribution, with an average salary of $44,219 per year, or $21.3 per hour.

Prior Authorization Representative

Clinical Associates, P.A.

Towson, MD • On-site

$38K - $52K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 5 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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