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Prior Authorization Representative Jobs in Missouri

BJC HealthCare

Prior Authorization Rep

Saint Louis, MO · Hybrid

$15.50 - $19.75/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

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

Authorization Spec-oncology

Saint Louis, MO · On-site

$17.50 - $23.25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... prior authorization with a strong attention to detail. Role Purpose This role is critical in the ... The role represents BJC with the highest standard of customer service, compassion and perform all ...

BJC HealthCare

Authorization Spec-oncology

Saint Louis, MO

$16.25 - $21.75/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... prior authorization with a strong attention to detail. Overview Preferred Qualifications Role ... The role represent BJC with the highest standard of customer service, compassion and perform all ...

BJC HealthCare

Authorization Spec-oncology

Saint Louis, MO · On-site

$17.75 - $25.56/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... prior authorization with a strong attention to detail. Overview Preferred Qualifications Role ... The role represent BJC with the highest standard of customer service, compassion and perform all ...

University of Rochester

$20.30 - $27.41/hr

UR URCA 205 H Compensation Range: $20.30 - $27.41 The referenced pay range represents the minimum ... Prior authorization functionality will be required for testing and services ordered by referred-to ...

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All JobsPrior Authorization Representative JobsPrior Authorization Representative Jobs in Missouri

Prior Authorization Representative information

See Missouri salary details

$23K

$41.5K

$72.2K

How much do prior authorization representative jobs pay per year?

As of Aug 16, 2026, the average yearly pay for prior authorization representative in Missouri is $41,477.00, according to ZipRecruiter salary data. Most workers in this role earn between $35,200.00 and $40,300.00 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 Missouri?

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

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

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

Prior Authorization Representative jobs near you
Infographic showing various Prior Authorization Representative job openings in Missouri 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 $41,477 per year, or $19.9 per hour.

Prior Authorization Rep

BJC HealthCare

Saint Louis, MO • Hybrid

$15.50 - $19.75/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 25 days ago

BJC Healthcare rating

7.6

Company rating: 7.6 out of 10

Based on 228 frontline employees who took The Breakroom Quiz

190th of 887 rated healthcare providers

Job description

Additional Information About the Role

Located at Barnes Jewish Mid Campus Center 

Additional Preferred Requirements

  • 8 am -4:30 PM 
  • Training will be onsite for 90 days 
  • No weekend or Holidays 
  • Hybrid Role after training 
  • Prefer experience: EPIC, Insurance background, and Prior Authorization experience 

Overview


Preferred Qualifications

Role Purpose

This role is critical in the financial clearance process which assists BJC hospitals enterprise wide in securing the appropriate authorization and/or Notice Of Admission (NOA) in order to prevent rescheduling the patient or risking net revenue loss. This position is required to obtain authorization on behalf of some physicians at Washington U school of medicine and BJC medical group and must maintain positive relationships. This position ensures technology is built in a way to accurately support the scripting and validation of authorization and NOA. Without the above we are limited in our collection of payment. The role represent BJC with the highest standard of customer service, compassion and perform all duties in a manner consistent with our mission, vision, values, and service standards. Facilitates certain components of the patients' entrance into any BJC facility, including insurance validation, benefit verification, pre-certification & financial clearance. Responsible for ensuring that the most accurate patient data is obtained and populated into the patient record, particularly authorization data and status. This team member must possess exceptional attention to detail & maintain knowledge & competence with insurance carriers, Medicare guidelines & federal, state & accreditation agencies.

Responsibilities

  • Requires a high level of attention to detail along with a high degree of accuracy. Key components of the process include validation of the following: patient information, scheduled test/surgery information, and insurance information. Ensures that the authorization detail placed in the patient's medical record is accurate. Expected to utilize critical thinking skills to research and resolve any mismatch in information which could involve various orders/scheduling, registration and insurance systems. Additionally, departmental processes around data capture must be followed and appropriate
  • Communication is a key. This position has high visibility and interaction with provider offices, insurance companies, as well as some patient interaction (typically phone calls for rescheduling appointments under the scope of the Ancillary Authorization process). This team member must communicate in a professional manner with particular emphasis on positive and respectful interaction with patients and offices. They must also be able to provide consistent excellent customer service in a variety of situations.
  • The ability to promote teamwork and employee engagement is everyone's responsibility. This team member will work to create an atmosphere of teamwork by contributing to opportunities to improve employee engagement and customer satisfaction. In all situations, they will engage others in a respectful and collaborative manner. They will seek opportunities for self-development (personal and technical) while achieving department objectives and goals.
  • This position is part of a multidisciplinary team which provides authorization support for multiple BJC Hospitals. May be responsible for supporting the Ancillary Authorization (scheduled outpatient services), Surgery Authorization (scheduled surgical procedures), or the NOA (Notice of Admission) processes within the BJC Pre-Arrival Team. As part of the authorization process, this team member will initiate contact with provider offices, payers and/or payer websites as well as access a variety of systems and tools to secure and validate authorization information. For Ancillary Authorizations, a review of medical records may be required if initiating the authorization request directly with a payer.
  • BJC has determined this is a safety-sensitive position. The ability to work in a constant state of alertness and in a safe manner is an essential function of this job.

    • Minimum Requirements

    Education

  • High School Diploma or GED

    • Experience

  • 2-5 years

    • Preferred Requirements

    Education

  • Associate's Degree

    • Experience

  • 5-10 years

    • Licenses & Certifications

  • CHAA

    • Benefits and Legal Statement

    BJC Total Rewards

    At BJC we're committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.

    • Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
    • Disability insurance* paid for by BJC
    • Annual 4% BJC Automatic Retirement Contribution
    • 401(k) plan with BJC match
    • Tuition Assistance available on first day
    • BJC Institute for Learning and Development
    • Health Care and Dependent Care Flexible Spending Accounts
    • Paid Time Off benefit combines vacation, sick days, holidays and personal time
    • Adoption assistance

    To learn more, go to our Benefits Summary.

    *Not all benefits apply to all jobs

    The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer

    Qualifications:

    Role Purpose

    This role is critical in the financial clearance process which assists BJC hospitals enterprise wide in securing the appropriate authorization and/or Notice Of Admission (NOA) in order to prevent rescheduling the patient or risking net revenue loss. This position is required to obtain authorization on behalf of some physicians at Washington U school of medicine and BJC medical group and must maintain positive relationships. This position ensures technology is built in a way to accurately support the scripting and validation of authorization and NOA. Without the above we are limited in our collection of payment. The role represent BJC with the highest standard of customer service, compassion and perform all duties in a manner consistent with our mission, vision, values, and service standards. Facilitates certain components of the patients' entrance into any BJC facility, including insurance validation, benefit verification, pre-certification & financial clearance. Responsible for ensuring that the most accurate patient data is obtained and populated into the patient record, particularly authorization data and status. This team member must possess exceptional attention to detail & maintain knowledge & competence with insurance carriers, Medicare guidelines & federal, state & accreditation agencies.

    Responsibilities

  • Requires a high level of attention to detail along with a high degree of accuracy. Key components of the process include validation of the following: patient information, scheduled test/surgery information, and insurance information. Ensures that the authorization detail placed in the patient's medical record is accurate. Expected to utilize critical thinking skills to research and resolve any mismatch in information which could involve various orders/scheduling, registration and insurance systems. Additionally, departmental processes around data capture must be followed and appropriate
  • Communication is a key. This position has high visibility and interaction with provider offices, insurance companies, as well as some patient interaction (typically phone calls for rescheduling appointments under the scope of the Ancillary Authorization process). This team member must communicate in a professional manner with particular emphasis on positive and respectful interaction with patients and offices. They must also be able to provide consistent excellent customer service in a variety of situations.
  • The ability to promote teamwork and employee engagement is everyone's responsibility. This team member will work to create an atmosphere of teamwork by contributing to opportunities to improve employee engagement and customer satisfaction. In all situations, they will engage others in a respectful and collaborative manner. They will seek opportunities for self-development (personal and technical) while achieving department objectives and goals.
  • This position is part of a multidisciplinary team which provides authorization support for multiple BJC Hospitals. May be responsible for supporting the Ancillary Authorization (scheduled outpatient services), Surgery Authorization (scheduled surgical procedures), or the NOA (Notice of Admission) processes within the BJC Pre-Arrival Team. As part of the authorization process, this team member will initiate contact with provider offices, payers and/or payer websites as well as access a variety of systems and tools to secure and validate authorization information. For Ancillary Authorizations, a review of medical records may be required if initiating the authorization request directly with a payer.
  • BJC has determined this is a safety-sensitive position. The ability to work in a constant state of alertness and in a safe manner is an essential function of this job.

    • Minimum Requirements

    Education

  • High School Diploma or GED

    • Experience

  • 2-5 years

    • Preferred Requirements

    Education

  • Associate's Degree

    • Experience

  • 5-10 years

    • Licenses & Certifications

  • CHAA
    • Education:UNAVAILABLEEmployment Type: FULL_TIME

    What BJC Healthcare employees say

    Pay

    Benefits

    Hours and flexibility

    Workplace

    Get the full story on Breakroom

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    About BJC Healthcare

    Sourced by ZipRecruiter

    BJC Healthcare, situated in Saint Louis, MO, US, is one of the largest healthcare organizations in the United States. Launched in 1993, BJC encompasses 15 hospitals and multiple health service organizations covering the metropolitan St. Louis area, mid-Missouri and Southern Illinois. This healthcare titan's services cover a vast field, from community health and wellness, to pediatric care, to advanced specialty care. BJC is well-known for its two nationally recognized hospitals, Barnes-Jewish Hospital and St. Louis Children's Hospital, both affiliated with Washington University School of Medicine. Its mission revolves around improving the health and well-being of the communities it serves through leadership, education, innovation, and excellence in medicine.

    Industry

    Health care and social assistance

    Company size

    10,000+ Employees

    Headquarters location

    Saint Louis, MO, US

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