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Prior Authorization Representative Jobs in Arizona

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.

Medix

Prior Authorization Coordinator

Chandler, AZ · On-site

$19 - $21/hr

The actual posting represents a position at one of our clients. Job Summary Our client is seeking a dedicated Prior Authorization Coordinator responsible for managing and streamlining the continuum ...

GI Alliance

Prior Authorizations Rep (30486)

Glendale, AZ · On-site

$17.50 - $22.25/hr

Obtain authorization via payer website or by phone and follow up regularly on pending cases ... Minimum 1 year prior authorization experience * Understanding of payer medical policy guidelines to ...

GI Alliance

Prior Authorizations Rep (30486)

Glendale, AZ · On-site

$15.50 - $19.75/hr

Obtain authorization via payer website or by phone and follow up regularly on pending cases ... Minimum 1 year prior authorization experience * Understanding of payer medical policy guidelines to ...

SMI IMAGING LLC

Pre-Authorization Representative

Phoenix, AZ · On-site

$39K - $54K/yr

Obtains pre-certification and registration prior to a patient's appointment. * Gathers pertinent ... Provides ongoing communication with patient regarding authorization and scheduling process. * Has ...

SMI IMAGING LLC

Pre-Authorization Representative

Phoenix, AZ · On-site

$39K - $54K/yr

Obtains pre-certification and registration prior to a patient's appointment. * Gathers pertinent ... Provides ongoing communication with patient regarding authorization and scheduling process. * Has ...

CapLeo Global

Customer Service Rep

Phoenix, AZ · On-site

$16 - $21.50/hr

Customer Service Representative As a healthcare customer service representative, you will be ... prior authorization requests Entering patient information into a customer information system ...

Global Pharma Tek

Customer Service Rep

Phoenix, AZ · On-site

$16 - $21.50/hr

Customer Service Rep Location : Phoenix, AZ 85034 Shift: 8:30 AM to 5 PM M-F Duration: 4 Month + As ... prior authorization requests Entering patient information into a customer information system ...

Quipt Home Medical

Customer Service Representative

Mesa, AZ · On-site

$15 - $20.50/hr

Customer Service Representative Position Reports To Branch Manager/CSR Director Position Summary As ... CMN Requirements and Prior Authorizations * Documentation Requirements of the Equipment * Patient ...

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All JobsPrior Authorization Representative JobsPrior Authorization Representative Jobs in Arizona

Prior Authorization Representative information

See Arizona salary details

$22.8K

$41.2K

$71.8K

How much do prior authorization representative jobs pay per year?

As of Aug 11, 2026, the average yearly pay for prior authorization representative in Arizona is $41,207.00, according to ZipRecruiter salary data. Most workers in this role earn between $34,900.00 and $40,100.00 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.
What are popular job titles related to Prior Authorization Representative jobs in Arizona? For Prior Authorization Representative jobs in Arizona, the most frequently searched job titles are:
What job categories do people searching Prior Authorization Representative jobs in Arizona look for? The top searched job categories for Prior Authorization Representative jobs in Arizona are:
Prior Authorization Representative jobs near you
Infographic showing various Prior Authorization Representative job openings in Arizona as of August 2026, with employment types broken down into 45% Full Time, and 55% Part Time. Highlights an 100% In-person job distribution, with an average salary of $41,207 per year, or $19.8 per hour.

Prior Authorization Rep

Arizona Priority Care

Chandler, AZ • Hybrid

$39K - $54K/yr

Full-time

Medical

Re-posted 22 days ago

Job description

Arizona Priority Care (AZPC) is an Integrated Provider Network focused on providing whole-person care to Senior and Medicaid populations, through advanced value-based models. Our provider network is comprised of more than 6,000 health care providers, including primary and specialty care physicians, hospitals and ancillary providers. We have operated in the Arizona market for more than 14 years, based in Chandler, Arizona, and are an affiliate of Heritage Provider Network. As a leading value-based provider organization, we are committed to improving the quality of care, providing excellent member and provider experiences all while reducing cost.

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. The PA Rep I works closely with all UM Staff, Prior Auth Supervisor, and management to maintain turnaround time requirements of the contracted health plan, regulatory bodies, and internal goals. Routinely interacts with physicians, their office staff and internal customers.

POSITION DUTIES & RESPONSIBILITIES

  • Assist in managing the incoming prior authorization request by following work direction given by the Prior Authorization management to ensure Routine/Standard and Urgent/Expedited prior authorizations are processed in the appropriate amount of time and in compliance with regulatory and health plan requirements.
  • Complete a minimum data entry or adjudication of 40 authorizations per day.
  • Assist in reviewing and distributing incoming prior authorization requests including identifying Urgent/Expedited vs Routine/Standard, verifying member eligibility, delegated vs non-delegated services, retro vs. future date of services, accuracy checking documentation, and routing to appropriate folder.
  • Perform data entry of prior authorization requests with a minimum of 97% accuracy including primary insurance or hospice verification, determine if requested services require prior authorization, and confirm request is not duplicative.
  • Perform adjudication of authorization requests with a minimum of 97% accuracy including quality checking data entry, reviewing historical utilization management history to include program enrollment and verifying if rendering provider and facility is contracted, any tasks related to processing a prior authorization request (provider loads, out of network (OON) credentialing, accreditation verification, etc.), providing redirect information for OON requests, and routing to the appropriate queue or vendor.
  • Contact the provider's office for additional information per CMS and AZPC policies and guidelines.
  • Make expedited determination notifications to member and provider.
  • Provide exceptional, courteous, and professional phone customer service.
  • Educate practitioners as needed with the Authorization/Referral process.
  • Perform as necessary accommodate to departmental change, workload and emergencies.
  • Maintain current knowledge of CMS and NCQA standards, and AZPC UM Policies and procedures.
  • Protect privacy for patients, providers, and employees; ensure all personal health information is kept confidential.
  • Demonstrate caring, empathy, patience, respect and compassion for all team members.
  • Demonstrate honesty and integrity in everyday activities.
  • Perform other duties as directed by management.

EDUCATION, TRAINING AND EXPERIENCE

  • Highschool Diploma or GED – Required.
  • Minimum of 1-year administrative healthcare related experience – Required.
  • Proficient knowledge of medical terminology, CPT-4, HCPCS, and ICD-10 – Required.
  • Working knowledge of computer applications, such as Microsoft Office applications.
  • Excellent oral and written communication skills.
  • Demonstrated ability to be detail-oriented and multi-task effectively.
  • Able to interact effectively with all levels of staff.

*This role requires 60 days FT in office presence, hybrid options will be available after the 60-day period.*