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Prior Authorization Representative Jobs in California

Sutter Health

Authorization Coordinator II

Sacramento, CA · On-site

$28.75 - $40.24/hr

... coverage, and determine if prior authorization is needed for said order. If needed, obtains ... represent significant departure from established guidelines. * Knowledge of Microsoft Office ...

Sutter Health

Authorization Coordinator II

Sacramento, CA · On-site +1

$28.75 - $40.24/hr

... coverage, and determine if prior authorization is needed for said order. If needed, obtains ... represent significant departure from established guidelines. * Knowledge of Microsoft Office ...

Sutter Health

Authorization Coordinator II

Sacramento, CA · On-site

$28.75 - $40.24/hr

... coverage, and determine if prior authorization is needed for said order. If needed, obtains ... represent significant departure from established guidelines. * Knowledge of Microsoft Office ...

Actalent

Client Support Representative

San Francisco, CA · On-site

$19.50 - $25.50/hr

Gather and document prior authorization information and conduct follow-up activities with insurance agents to complete outstanding tasks. * Capture complete and accurate insurance verification and ...

New

Actalent

Patient Access Representative

San Francisco, CA · On-site

$20.25 - $26/hr

Gather and document prior authorization information and conduct follow-up activities with insurance agents to complete outstanding tasks. * Capture complete and accurate insurance verification and ...

New

FFF Enterprises

Authorization Coordinator I

Temecula, CA · On-site

$18.50 - $22.75/hr

... prior to shipping. Essential Functions and Duties * Initiates the re-authorization process by ... Always represent the Company in a professional manner and appearance. * Understand and internalize ...

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Showing results 21-40

All JobsPrior Authorization Representative JobsPrior Authorization Representative Jobs in California

Prior Authorization Representative information

See California salary details

$24.2K

$43.6K

$76K

How much do prior authorization representative jobs pay per year?

As of Aug 23, 2026, the average yearly pay for prior authorization representative in California is $43,640.00, according to ZipRecruiter salary data. Most workers in this role earn between $37,000.00 and $42,400.00 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.

What are popular job titles related to Prior Authorization Representative jobs in California?

For Prior Authorization Representative jobs in California, the most frequently searched job titles are:

What job categories do people searching Prior Authorization Representative jobs in California look for?

The top searched job categories for Prior Authorization Representative jobs in California are:

Prior Authorization Representative jobs near you
Infographic showing various Prior Authorization Representative job openings in California as of August 2026, with employment types broken down into 46% Full Time, and 54% Part Time. Highlights an 100% In-person job distribution, with an average salary of $43,640 per year, or $21 per hour.

Medication Authorization Specialist

Eisenhower

Rancho Mirage, CA • On-site

$19.72 - $29.95/hr

Full-time

Re-posted 7 days ago

Job description

Default Work Shift:

Day (United States of America)

Hours:

40

Salary range:

$19.72 - $29.95

Schedule:

Full Time

Shift Hours:

8 Hour employee

Department:

Administration (ELCCC)

Job Objective:

Under the supervision of the Business Office Manager, submits requests for medication authorization to insurance companies and provides documentation to support complex infusion treatments.

Job Description:

Education:Required: High school diploma, GED or higher level degreeLicensure/Certification:N/AExperience:Preferred: Experience reviewing medication authorizations in a medical office; experience working with EMR systems; experience in oncologyReports To: Business Office Manager, Multiple Service LinesSupervises: N/A Ages of Patients: Adult, GeriatricBlood Borne Pathogens: Minimal/ No Potential

Skills, Knowledge, Abilities:

Ability to effectively communicate and write clearly, Exceptional customer service skills, Insurance knowledge, both government and commercial, Self-starter; driven to take action without needing prompting, Strong computer skills

Essential Responsibilities

1.Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.2.Ensures the accurate and timely processing of injection and infusion orders.3.Works with third-party insurance representatives and EMC clinical staff to process prior authorization requests for infusions and injections.4.Obtains required clinical documentation for prior authorization (ex: progress notes, labs, diagnoses codes, previous therapies, etc.), ensuring all needed clinical records are collected in order to have treatment authorized on the first attempt.5.Reviews authorization queue for orders and makes sure the schedule is clear for the coming days.6.Observes payor contractual authorization requirements.7.Utilizes website portals and electronic options (when available) to submit authorization requests. Employs other communication sources when required by the payor.8.Works with management to identify payor trends, preferred medications, biosimilars and/or generics.9.Performs other duties as assigned.

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