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Prior Authorization Representative Jobs (NOW HIRING)

IVX Health

Prior Authorization Coordinator

$19 - $23.50/hr

Support Patients and Providers - Communicate effectively with patients, clinical staff, and insurance representatives regarding the Prior Authorization process. * Ensure Compliance and Process ...

IVX Health

Prior Authorization Coordinator

Brentwood, TN · On-site +1

$17.50 - $21.75/hr

Support Patients and Providers - Communicate effectively with patients, clinical staff, and insurance representatives regarding the Prior Authorization process. * Ensure Compliance and Process ...

New

Medix

Prior Authorization Specialist

Phoenix, AZ · On-site

$20 - $24/hr

The actual posting represents a position at one of our clients. Job Summary Our client is seeking a dedicated Prior Authorization Specialist. The primary responsibility is to communicate with ...

System One

Authorization Rep

Tulsa, OK · On-site

$17 - $20/hr

Authorization Rep Location: Tulsa, OK Type: Contract To Hire Compensation: $17-20/hr Work Model ... Obtain prior authorizations and pre-certifications for medical procedures, diagnostic testing ...

System One

Authorization Rep

Tulsa, OK · On-site

$17 - $20/hr

Authorization Rep Location: Tulsa, OK Type: Contract To Hire Compensation: $17-20/hr Work Model ... Obtain prior authorizations and pre-certifications for medical procedures, diagnostic testing ...

Cinq Group

Prior Authorization Specialist

Altamonte Springs, FL · On-site

$16.75 - $22.50/hr

Coordinates appointment of representative document with patient and physician office. * Completes status check with insurance company regarding receipt of prior authorization and appeal and approval ...

System One

Authorization Rep

Tulsa, OK · On-site

$17 - $20/hr

Authorization Rep Location: Tulsa, OK Type: Contract To Hire Compensation: $17-20/hr Work Model ... Obtain prior authorizations and pre-certifications for medical procedures, diagnostic testing ...

System One

Authorization Rep

Tulsa, OK · On-site

$17 - $20/hr

Authorization Rep Location: Tulsa, OK Type: Contract To Hire Compensation: $17-20/hr Work Model ... Obtain prior authorizations and pre-certifications for medical procedures, diagnostic testing ...

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Prior Authorization Representative information

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$44.2K

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How much do prior authorization representative jobs pay per year?

As of Jul 24, 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.

What does a prior authorization rep do?

A prior authorization representative reviews and processes requests for medical services or medications that require approval from insurance companies before treatment. They verify patient information, ensure documentation is complete, and communicate with healthcare providers and insurers to obtain necessary approvals, often using specialized software. This role helps ensure that patients receive authorized care while complying with insurance policies.

How much do precertification specialists make?

Precertification specialists, also known as prior authorization representatives, typically earn between $35,000 and $55,000 annually, depending on experience, location, and employer. They often require strong knowledge of insurance policies and medical billing systems, with some roles offering additional certifications to increase earning potential.

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.

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.

Is prior authorization a stressful job?

Prior Authorization Representatives often work in fast-paced healthcare environments where accuracy and efficiency are important. The job can be stressful due to tight deadlines, high call volumes, and the need to interpret complex insurance policies, but experience and strong organizational skills can help manage the workload.

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 jobs pay 4000 a week without a degree?

Prior Authorization Representatives typically do not earn $4,000 weekly; however, some high-paying roles in sales, real estate, or specialized trades can reach that level without a degree. These jobs often require strong communication skills, experience, or certifications and may involve commission or performance-based pay structures.
More about Prior Authorization Representative jobs
What cities are hiring for Prior Authorization Representative jobs? Cities with the most Prior Authorization Representative job openings:
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Prior Authorization Representative jobs near you
Infographic showing various Prior Authorization Representative job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 87% Full Time, 10% Part Time, and 2% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $44,219 per year, or $21.3 per hour.
Prior Authorization Specialist

Prior Authorization Specialist

Equitas Health, Inc.

Columbus, OH • On-site

$18.13 - $21.78/hr

Full-time

Posted 10 days ago

Job description

ORGANIZATION INFORMATION:

Established in 1984, Equitas Health is a regional not-for-profit community-based healthcare system and federally qualified community health center look-alike. Its expanded mission has made it one of the nation’s largest HIV/AIDS, lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) healthcare organizations. With 22 offices in 12 cities, it serves more than 67,000 individuals in Ohio, Kentucky, and West Virginia each year through its diverse healthcare and social service delivery system focused around: primary and specialized medical care, retail pharmacy, dental, behavioral health, HIV/STI prevention, advocacy, and community health initiatives.

HOURLY RATE: $18.13-$21.78

BENEFITS:
  • PTO
  • Vision
  • Dental
  • Health
  • 401k
  • Sick time

POSITION SUMMARY:
The Prior Authorization Specialist handles all prior authorizations, third party appeals, and pending third party payer issues across all Equitas Health medical centers. This individual will work with internal and external pharmacies, CoverMyMeds, the EHR, and all Equitas Health health center providers to facilitate prior authorization completion. This individual must be able to work in conjunction with the pharmacy department and health center staff to facilitate the prior authorization process.
ESSENTIAL JOB FUNCTIONS:
The Prior Authorization Specialist is responsible for handling all prior authorizations, appeals, and third party medication disputes for providers at Equitas Health. The Prior Authorization Specialist will be required to communicate with prescribers, pend medication changes, and maintain exceptional documentation in the patient health record. The staff member will also be in constant communication with internal pharmacies, external pharmacies, and patients waiting on prior authorizations. Essential job functions include, but are not limited to, driving or having reliable transportation, written and verbal communication, utilizing a computer for typing, multi-system use/maintenance, and attending meetings.
MAJOR AREAS OF RESPONSIBILITIES:

  • Complete prior authorizations submission within established time frame.
  • Collaborate with providers to manage appeals and/or peer-to-peer discussion with third party representatives.
  • Ensure proper documentation is maintained in the EHR.
  • Work with clinical pharmacist team to provide potential therapeutic substitutions to prescribers
  • Communicate with the clinical team on the status of prior authorizations or changes that must be made for therapy to continue for the patient.
  • Maintain constant communication with the internal and external pharmacy teams for medication processing.
  • Inform patients when prior authorizations are approved.
  • Provide data on prior authorizations as needed to Senior Leadership.
  • Other duties as assigned by the Prior Authorization Supervisor, Director of Nursing, and Leadership.
  • Comply with the Equitas Health Care Corporate Compliance Standards of Conduct and related policies and procedures.
  • Demonstrate unconditional positive regard to clients and conduct all aspects of job responsibilities.
  • Continuously grow and develop cultural competency, exhibiting an understanding, awareness, and respect for diversity.
  • Contribute to a positive work environment by demonstrating unconditional positive regard to all Equitas Health employees, interns, etc. with an understanding, awareness, and respect for diversity.


EDUCATION/LICENSURE:

  • Medical Assistant, Certified Pharmacy Technician or Registered Pharmacy Technician (must be registered with State of Ohio Board of Pharmacy).


Knowledge, Skills, Abilities and other Qualifications:

  • Experience working in medical records preferred.
  • Must be able to accurately and effectively meet established deadlines
  • Experience with prior authorizations preferred.
  • Strong attention to detail.
  • Ability to be flexible in working hours.
  • Must ensure detailed and thorough documentation.
  • Exemplary written and verbal communication skills.
  • Knowledge of healthcare terminology.
  • Must have sensitivity to, interest in and competence in cultural differences, HIV/AIDS, minority health, sexual practices, chemical dependency and a demonstrated competence in working with persons of color, and gay/lesbian/bisexual/transgender community.
  • Proficiency in all Microsoft Office applications, computers, email, web-based systems and electronic health records.
  • Reliable transportation, driver’s license and proof of auto insurance required.

OTHER INFORMATION:

Background and reference checks will be conducted. In accordance with Equitas Health’s Drug-Free Workplace Policy, pre-employment drug testing will be administered. Hours may vary, including working some evenings and weekends based on workload. Individuals are not considered applicants until they have been asked to visit for an interview and at that time complete an application for employment. Completing the application does not guarantee employment. EOE/AA