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Prior Authorization Jobs in Delaware (NOW HIRING)

RecruitWell

Dermatology Physician

Wilmington, DE

$168.27 - $264.42/hr

Prior Authorization Department, In-House Lab, In-House Pathology, In-House Plastics, Research Center, Call Center, Billing, Medical and Facility Operations, Provider Relations and Patient Liaison

Beebe Healthcare

CAT SCAN - DIA SPECIALIST

Lewes, DE · On-site

$17.75 - $27.51/hr

Exam, contrast use, diagnosis and authorization number matching appropriate CPT coding. Request order changes to be faxed prior to exam date. Check patient schedule first thing in the morning for ...

Bebee Healthcare

CAT SCAN - DIA SPECIALIST

Lewes, DE · On-site

$17.75/hr

Exam, contrast use, diagnosis and authorization number matching appropriate CPT coding. Request order changes to be faxed prior to exam date. Check patient schedule first thing in the morning for ...

Bayhealth

Patient Access Specialist I

Milford, DE · On-site

$16.75 - $22.25/hr

Complies with EMTALA regulation when creating the quick registration account (when applicable). 6. Ensure authorizations (pre-certifications, prior authorization, referrals) are obtained prior to ...

Bayhealth

Patient Access Specialist I

Dover, DE · On-site

$17.25 - $23/hr

Complies with EMTALA regulation when creating the quick registration account (when applicable). 6. Ensure authorizations (pre-certifications, prior authorization, referrals) are obtained prior to ...

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All JobsPrior Authorization JobsPrior Authorization Jobs in Delaware

Prior Authorization information

See Delaware salary details

$13

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$32

How much do prior authorization jobs pay per hour?

As of Jul 16, 2026, the average hourly pay for prior authorization in Delaware is $20.91, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $23.08 per hour, depending on experience, location, and employer.

How to become a prior authorization specialist?

To become a prior authorization specialist, candidates typically need a high school diploma or equivalent, along with experience in healthcare or insurance billing. Relevant skills include knowledge of medical terminology, insurance policies, and proficiency with electronic health record (EHR) systems; certifications such as Certified Professional Coder (CPC) can enhance job prospects.

What jobs pay $4000 a week without a degree?

Jobs that can pay $4,000 a week without a degree include certain sales roles, real estate agents, commercial pilots, and skilled trades such as electricians or plumbers with experience. These positions often require specialized skills, certifications, or licensing but do not necessarily require a college degree. High earnings typically depend on experience, performance, and the industry environment.

How much do precertification specialists make?

Precertification specialists typically earn between $35,000 and $55,000 annually, depending on experience, location, and employer. They often require knowledge of insurance policies and medical billing systems, and some roles may offer additional benefits or bonuses.

What Is Prior Authorization?

Prior authorization is a check done by insurance companies and other third-party payers to determine whether or not they should pay for a medical procedure or specific medication. Factors that can trigger prior authorization requests include things like age, the availability of alternative medicines, or the need to check for drug interactions. If they reject the prior authorization, payers often require doctors to attempt the insurance company's preferred procedure and verify unsuccessful results before accepting an alternative treatment plan. Pre-authorization requests can take up to 30 days, though insurance companies and healthcare providers are continuing to work on ways to cut this time down.

What are the key skills and qualifications needed to thrive as a Prior Authorization Specialist, and why are they important?

To thrive as a Prior Authorization Specialist, you need strong knowledge of medical terminology, insurance processes, and healthcare regulations, typically supported by a high school diploma or associate degree in a healthcare-related field. Familiarity with electronic medical records (EMR) systems, insurance portals, and authorization management software is essential. Attention to detail, effective communication, and problem-solving abilities help you navigate complex cases and collaborate with providers and payers. These skills ensure accurate and timely processing of authorizations, minimizing delays in patient care and reducing administrative errors.

What are some common challenges faced by Prior Authorization specialists, and how can applicants prepare for them?

Prior Authorization specialists often encounter challenges such as navigating complex insurance policies, managing high volumes of requests, and communicating effectively with both healthcare providers and insurance representatives. To prepare for these challenges, applicants should develop strong organizational skills, attention to detail, and a good understanding of medical terminology and insurance guidelines. Familiarity with electronic health records (EHR) systems and the ability to multitask in a fast-paced environment are also valuable assets in this role.

What is the difference between Prior Authorization vs Medical Billing Specialist?

AspectPrior AuthorizationMedical Billing Specialist
CredentialsTypically requires knowledge of insurance policies, healthcare regulations, and sometimes certifications like NCQA or AHIPRequires knowledge of coding, billing procedures, and often certifications like CPC or CCS
Work EnvironmentHealthcare provider offices, insurance companies, or hospitalsMedical offices, billing companies, or healthcare facilities
Employer & Industry UsageUsed by healthcare providers and insurers to approve treatments or proceduresUsed by healthcare providers and billing companies to process claims and payments

While both roles are essential in healthcare administration, Prior Authorization focuses on obtaining approval for treatments, whereas Medical Billing Specialists handle the financial aspects of claims processing. Understanding their differences helps clarify their distinct responsibilities within the healthcare system.

What is prior authorization in healthcare?

Prior authorization is a process used by health insurance companies to determine if they will cover a prescribed procedure, service, or medication. Before the provider delivers the service, they must receive approval from the insurer. This process helps control costs and ensures that the service or medication is medically necessary. It often involves submitting documentation and waiting for a decision, which can sometimes delay patient care. Patients and providers should check with insurance companies to understand which services require prior authorization.

What career paths follow prior authorization?

Careers following prior authorization typically include roles such as medical billers, claims processors, healthcare administrators, and utilization review specialists. These positions often require knowledge of insurance policies, medical coding, and healthcare regulations, and may involve working in insurance companies, healthcare providers, or pharmacy benefit management companies.
More about Prior Authorization jobs
What are the most commonly searched types of Prior Authorization jobs in Delaware? The most popular types of Prior Authorization jobs in Delaware are:
What are popular job titles related to Prior Authorization jobs in Delaware? For Prior Authorization jobs in Delaware, the most frequently searched job titles are:
What job categories do people searching Prior Authorization jobs in Delaware look for? The top searched job categories for Prior Authorization jobs in Delaware are:
What cities in Delaware are hiring for Prior Authorization jobs? Cities in Delaware with the most Prior Authorization job openings:
Prior Authorization jobs near you
Infographic showing various Prior Authorization job openings in Delaware as of July 2026, with employment types broken down into 89% Full Time, 7% Part Time, and 4% Contract. Highlights an 100% In-person job distribution, with an average salary of $43,497 per year, or $20.9 per hour.
Referral & Authorization Care Coordinator

Referral & Authorization Care Coordinator

Oshi Health

Delaware City, DE • Remote

$47K - $52K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 8 days ago

Job description

Referral and Authorization Coordinator

Reports To: Manager, Care Operations
Locations Hiring From: Arizona, Delaware, Florida, Georgia, Idaho, Indiana, Louisiana, Missouri, New Hampshire, North Carolina, South Carolina, Tennessee, Texas, Vermont, Virginia ONLY. Must currently reside and plan on residing in the entire employment.
Schedule: Monday- Friday 12-8pm EST and Monday- Friday 9-5pm EST
Employment Type: Full-Time

Role Overview

As our Care Coordinator specializing in Prior Authorizations & Referrals, you will manage back-office responsibilities including referral management, prior authorizations, specialty pharmacy & infusions, and medical records to help deliver and implement clinical strategies and support member care coordination in collaboration with a multidisciplinary clinical team. You will use a high level of attention to detail, organization, and communication skills to obtain, manage, and follow up on member referrals and prior authorizations to ensure key care plan goals are met.

What You'll Do: Key Responsibilities

  • Collaborate with a multidisciplinary team of care providers (including NPs, RDs, Behavioral Health Providers) to provide a whole-person approach to member care.
  • Coordinate, track, and communicate patient referrals, prior authorizations, and medical records to promote team awareness and patient safety.
  • Provide complete and accurate registration of referrals and authorizations, including patient demographics, insurance information, and clinical documentation to external providers and specialty pharmacies.
  • Offer proficient knowledge of referrals, insurance requirements, and the prior authorization process to internal and external resources, eliminating barriers to care and following up on progress toward key goals.
  • Apply knowledge of CPT and ICD-10 codes to obtain authorizations in a timely manner while demonstrating understanding of payer medical policy guidelines.
  • Initiate appeals for denied authorizations and maintain close follow-up to ensure positive member outcomes.
  • Engage in external coordination of pharmacy support services to ensure members receive all necessary support throughout the prior authorization process.
  • Assist members in accessing services, providing personalized customer service while maintaining close communication with the care coordination team.
  • Manage key reports and track relevant data to identify successes and drive refinements in operational processes.

What We're Looking For: Qualifications & Requirements

Required

  • Bachelor's Degree in Healthcare administration or equivalent course work
  • Minimum of 2-3 years experience in healthcare coordination, care, or case management within a remote digital healthcare space
  • Completed degree in a health and science related field (biology, psychology, health science, nutrition, nursing, etc.).
  • Fluent in healthcare terminology with a working understanding of clinical concepts.
  • Background knowledge navigating health insurance plans and coverage, with ability to provide benefits breakdown analysis to consumers.
  • Comfortable and competent with common administrative technologies (Zoom, Slack, Office or equivalent), charting electronically in EMR/EHR systems

Preferred

  • Experience working in telehealth or a digital health environment.
  • Strong critical thinking skills with ability to triage accurately and escalate appropriately.
  • Experience in a high-growth startup or mission-driven healthcare organization.

Compensation & Benefits

  • Salary Range: $47,000 – $52,000 (commensurate with experience)
  • Health Benefits: Employer-sponsored medical, dental, and vision coverage
  • Time Off: Unlimited PTO + 11 paid company holidays
  • Retirement: Eligibility to contribute to 401(k)
  • Work Style: Remote-first — work from home anywhere within our approved states
  • Growth: Tailored professional development opportunities as we scale
  • Life Concierge: Access to Overalls, because we know life happens

About Oshi Health

Oshi Health is a virtual digestive health practice on a mission to transform GI care. We combine compassionate, multidisciplinary care with innovative technology to help people with chronic digestive conditions get the answers and relief they deserve. When you join Oshi, you're joining a team and a mission that's changing what great healthcare looks like. Oshi Health is revolutionizing GI care with a digital clinic model that provides easy, convenient access to an integrated and multidisciplinary care team that takes a whole-person approach to diagnosing, managing, and treating digestive health conditions. We take time to get to know each patient, develop a personalized, whole-person care plan that includes identification of symptom triggers and prescription of evidence-based interventions, including medications, dietary changes, and mental health support.

For Every Oshi Team Member We Want:

  • Genuine passion for improving patient lives and transforming GI care
  • Strong communication skills and emotional intelligence
  • Comfort in a fast-paced, remote-first, mission-driven environment
Compensation Range
$47,000—$52,000 USD

Note: This job description serves as a general overview and may be subject to change based on organizational needs and requirements.

Oshi Health is an equal opportunity employer that is committed to creating a diverse work environment. To do that, we champion a workplace where each and every person is treated with dignity and respect and is valued for their unique perspective and contributions.
Oshi Health's policy is to maintain a working environment that encourages mutual respect, promotes harmonious and congenial relationships between employees, and is free from all forms of discrimination and harassment of any employee (or applicant for employment or service provider) by anyone, including supervisors, co-workers, vendors, or clients. Harassment and discrimination in any manner or form is expressly prohibited. There is no tolerance for discrimination or unequal treatment of any kind on the basis of race, color, religion, creed, gender, sex, sexual orientation, gender identity or expression, pregnancy, sexual and reproductive health decisions, national origin, age, disability, genetic information, marital status or civil partnership/union status, familial status, military or veteran status, predisposition or carrier status, domestic violence victim status, alienage or citizenship status, unemployment status, sexual violence or stalking victim status, caregiver status, or any other characteristic protected by law.

This practice applies to all terms, conditions and privileges of employment including, but not limited to, recruitment, selection, promotion, demotion, transfer, layoff, rehire, termination of employment, development and training, compensation, benefits and retirement.

For more information, visit us at www.oshihealth.com

Oshi Health will never contact job candidates via text message or any other messaging platform including WhatsApp, Signal, and Telegram. All official correspondence will occur through email. We will never ask you to share bank account information, cash a check from us, or purchase software or equipment as part of your interview or hiring process. If you have concerns, please reach out to careers@oshihealth.com, and we'll confirm whether you're engaging with one of our Oshi teammates!