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Prior Authorization Representative Jobs (NOW HIRING)

Harmony Home Health

Authorization Representative

Murray, UT · On-site

$37K - $51K/yr

Authorization Representative We have an exciting opportunity for an Authorization Representative at ... Obtain prior authorization for services from clients' medical insurance carriers. Review client ...

1840 & Company

$16.75 - $22.25/hr

Prior Authorization Specialist We are seeking a detail-oriented and experienced Prior Authorization ... Fluency in English is required to effectively communicate with insurance representatives and team ...

1840 & Company

$16.75 - $22.25/hr

Prior Authorization Specialist We are seeking a detail-oriented and experienced Prior Authorization ... Fluency in English is required to effectively communicate with insurance representatives and team ...

HHAU

Authorization Representative

Salt Lake City, UT · On-site

$38K - $53K/yr

Immediate Opening: Authorization Representative We have an exciting opportunity for an ... Obtain prior authorization for services from clients' medical insurance carriers. * Review client ...

Equitas Health

Prior Authorization Specialist

Columbus, OH · On-site

$18.13 - $21.78/hr

Prior Authorization Specialist Established in 1984, Equitas Health is a regional not-for-profit ... representatives. * Ensure proper documentation is maintained in the EHR. * Work with clinical ...

Equitas Health

Prior Authorization Specialist

Columbus, OH · On-site

$18.13 - $21.78/hr

The Prior Authorization Specialist handles all prior authorizations, third party appeals, and ... representatives. * Ensure proper documentation is maintained in the EHR. * Work with clinical ...

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Prior Authorization Representative information

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$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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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?

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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 I

University of Utah Health

Salt Lake City, UT • On-site, Remote

$16.50 - $21/hr

Full-time

Posted 3 days ago

New

University Of Utah Health rating

7.7

Company rating: 7.7 out of 10

Based on 142 frontline employees who took The Breakroom Quiz

157th of 887 rated healthcare providers

Job description

Overview
This position is primarily remote work, but candidate must reside within the state of Utah for this one.
Top candidates will also have some prior working experience in Prior Authorizations.
As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA
This position is responsible to secure outpatient accounts by performing insurance verification, obtaining benefit information, calculating patient estimates, and obtaining prior authorization before services are rendered. This position works with physicians, nurses, clinic managers, and financial advocates to resolve issues that arise during the prior authorizations process. This position is not responsible for providing care to patients.
Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.
Responsibilities
Essential Functions
  • Verifies insurance eligibility, benefits, network status, and creates pre-service liability estimate.
  • Ensures accurate ICD, CPT codes and related medical records are submitted in the authorization request.
  • Secures prior authorizations for outpatient imaging and in office scheduled services.
  • Acts as a liaison between the payer and clinic schedulers/medical support staff.
  • Follows up on delayed or denied authorization requests and escalates for resolution.
  • Creates detailed documentation and maintains/stores the authorization paper trail.
  • May work to resolve claims denials related to the prior authorization.
Knowledge / Skills / Abilities
  • Basic knowledge of accounting, word processing, and spreadsheets.
  • Demonstrated critical thinking and ability to analyze information and problem solve.
  • Demonstrated professional verbal/written communication skills.
  • Ability to work independently within a team setting.
  • Ability to adapt to a dynamic work environment.
  • Demonstrated ability to prioritize and manage a large workload in stressful situations.
  • Ability to multitask.
  • Familiarity with human anatomy and medical terminology.
  • Demonstrated ability to complete work with a high level of detail and accuracy.
  • Ability to meet process time standards.
  • Ability to provide professional and courteous service in all interactions with internal and external customers.
  • Ability to navigate through various hospital software applications, including Epic ADT/Prelude, Cadence, Epicare, Referrals and Auth/Cert applications.
  • Ability to navigate and maneuver through multiple web sites.

Qualifications
Required
  • Two years of experience in a health care financial setting, or the equivalency.

Qualifications (Preferred)
Preferred
  • Previous experience with medical insurance and prior-authorizations.
  • ICD/CPT coding experience.
  • Outpatient or Radiology prior authorizations experience.
Working Conditions and Physical Demands
Employee must be able to meet the following requirements with or without an accommodation.
  • This is a sedentary position that may exert up to 10 pounds and may lift, carry, push, pull, or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.

Physical Requirements
Listening, Sitting, Speaking

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