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Prior Authorization Jobs in Delaware (NOW HIRING)

Brandywine Urology Consultants

Triage Nurse

New Castle, DE · On-site

$29 - $36/hr

... Obtain prior authorizations for medications and durable medical equipment · Handle new, renewal, and/or refill prescriptions for providers via EMR system and checking all prior disbursement to ...

Brandywine Urology Consultants

Triage Nurse

New Castle, DE · On-site

$29 - $36/hr

... prior authorizations for medications and durable medical equipment • Handle new, renewal, and/or refill prescriptions for providers via EMR system and checking all prior disbursement to patient ...

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All JobsPrior Authorization JobsPrior Authorization Jobs in Delaware

Prior Authorization information

See Delaware salary details

$13

$20

$32

How much do prior authorization jobs pay per hour?

As of Aug 9, 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.

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.

How do I become a prior authorization specialist?

To become a prior authorization specialist, you typically need a high school diploma or equivalent and gain 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 Medical Administrative Assistant (CMAA) can also enhance job prospects.

What is a prior authorization job?

A prior authorization job involves reviewing and processing requests from healthcare providers to approve specific medical treatments, medications, or procedures before they are administered. The role requires knowledge of insurance policies, medical terminology, and attention to detail, often utilizing electronic health record systems. It is essential for ensuring that treatments meet insurance criteria and are covered under the patient's plan.

What are the career paths in prior authorization?

Careers in prior authorization typically include roles such as prior authorization specialists, medical reviewers, and healthcare administrators. Advancement can lead to supervisory or managerial positions, and professionals often develop skills in healthcare regulations, insurance policies, and medical coding. Certifications in medical billing and coding can enhance career growth in this field.

What is prior authorization?

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.
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 August 2026, with employment types broken down into 74% Full Time, 24% Part Time, and 2% Contract. Highlights an 91% In-person, 2% Hybrid, and 7% Remote job distribution, with an average salary of $43,497 per year, or $20.9 per hour.

Front Office Coordinator - Wilmington (Midway Pl), DE

Pivot Physical Therapy

Wilmington, DE • On-site

$16 - $20.75/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 11 days ago

Job description

Position Overview
About Us:
At Athletico, we believe in the power of support - because a little help can lead to extraordinary achievements. Physical therapy isn't just about recovery; it's about transformation. Our team thrives on providing life-changing care for our patients, and we know that achieving this begins with taking care of our own.
Our mission is simple yet powerful: Extraordinary people improving lives.
Position Summary:
The Patient Experience Coordinator (PEC) ensures accurate patient intake and financial clearance processes, delivering a seamless and exceptional front-office experience while maintaining compliance, safeguarding data integrity, and supporting revenue cycle performance. This role reports directly to the Clinic Manager and collaborates closely with clinical teams, while receiving functional and technical support from the Patient Experience Specialist (PES).
Benefits offered with this full-time position:
  • Medical & Rx, Dental and Vision (eligibility begins day one of employment)
  • HSA, Healthcare FSA, Dependent Care FSA
  • Progyny Fertility Benefit
  • Critical Illness, Accident, & Hospital Indemnity Insurance
  • Company Paid Basic Life / AD&D
  • Supplemental Life Insurance (Employee, Spouse, Child)
  • Company Paid Short-Term & Long-Term Disability
  • Long-Term Disability Buy-Up Option
  • Company Paid Maternity & Parental Leave
  • Adoption & Surrogacy Expense Reimbursement
  • KinderCare Discount
  • Legal & Credit Monitoring
  • 15 days PTO (accruing starts immediately upon hire)
  • 6 Major Holidays off plus 2 floating holidays yearly
  • Additional compensation opportunities on top of base pay
  • Bereavement Time Off & Resources
  • Commuter: Pre-Tax Transit & Parking
  • Retirement 401(k) (for 21+) w/ Per-Pay Company Match
  • SoFi Financial Wellness Tools & Loan Resources
  • HUSK Fitness Resources & Gym Discounts
  • Home, Auto, and Pet Insurance
  • Employee Assistance Program (EAP)
  • Employee Discount Program
  • Learn more by checking out our 2026 Athletico's Benefits Summary.

Essential Duties and Responsibilities:The below is not an exhaustive list of duties and you will be expected to perform different tasks as necessitated by your changing role within the organization and the overall business objectives of the organization.
  • Deliver an exceptional front-office experience by greeting patients warmly, resolving issues promptly, and ensuring positive interactions at every touchpoint.
  • Accurately complete patient intake and registration, including demographic verification, insurance eligibility, and authorization requirements, to maintain data integrity and compliance.
  • Educate patients on financial responsibilities, payment options, and digital tools (e.g., patient portal) to improve transparency and engagement.
  • Collect time-of-service payments and meet established collection targets to support revenue cycle performance.
  • Manage clinic scheduling workflows to optimize provider availability and patient access, ensuring alignment with organizational standards.
  • Monitor and achieve key performance indicators (KPIs) for registration accuracy, insurance verification turnaround, and patient satisfaction.
  • Collaborate with Patient Experience Specialists (PES), Billing, and Clinical Operations teams to resolve complex insurance or scheduling issues and escalate as needed.
  • Utilize EMR systems, dashboards, and reporting tools to track patient outcomes, identify discrepancies, and support continuous improvement initiatives.
  • Coordinate communication of patient progress notes and plans of care to referral sources in a timely and accurate manner.
  • Support clinic engagement by organizing patient milestone celebrations and community-building activities in partnership with the clinical team.
  • Participate in ongoing training and cross-training programs to maintain proficiency in front-office operations and contribute to team flexibility.
  • Organizes activities (e.g., patient's goal celebrations, holiday celebrations) in coordination with the clinical team.
  • Provide Rehab Aide cross training on front office duties.

Qualifications:
  • Education:
    • High School Diploma or GED
  • Knowledge and Technical Skills:
    • Excellent customer service skills
    • Proficient with the use of MS Office, Outlook and Excel
    • Knowledge of healthcare insurance benefits and coverage preferred
    • Experience with requesting and managing customer payments preferred
  • Work Experience
    • 1-2 years of customer service required
    • 1-2 years of healthcare administration preferred

Knowledge and Technical Skills:
  • Demonstrated ability to deliver exceptional customer service and resolve issues promptly in a high-volume, patient-facing environment
  • Proficiency in electronic medical record (EMR/EHR) systems and scheduling platforms; ability to navigate dashboards and reporting tools for data accuracy
  • Strong understanding of insurance verification processes, prior authorization requirements, and financial clearance workflows
  • Working knowledge of HIPAA compliance and patient privacy standards
  • Skilled in Microsoft Office Suite (Outlook, Excel, Word) and collaboration tools (Teams); ability to learn new technologies quickly
  • Excellent written and verbal communication skills, including the ability to explain financial responsibilities and digital tools to patients clearly
  • Strong organizational and time management skills with attention to detail and accuracy in data entry
  • Ability to meet or exceed performance metrics (e.g., registration accuracy, collection targets) and adapt to continuous process improvements

Language Skills:
  • Ability to read, write and speak English proficiently

Physical Demands:
  • Ability to fulfill office activities including but not limited to remain stationary for extended periods of time (i.e. while working at a desk), stoop/kneel/crouch, travel around the office, communicate with others (verbal and written), and use fine motor skills including fine hand manipulation and keyboarding.
  • Ability to see at close range, distance vision, peripheral vision, depth perception, and the ability to adjust focus

Work Environment:
  • Consistent with a standard office environment, noise level is low with little to no extra ordinary environmental factors.

Athletico provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
Salaried ranges listed are for full time (40 hour) employees. Additional pay such as incentive, GAP, overtime, and stipends are subject to the rules of each program and may not be available in all locations. Individual base pay depends on various factors, in addition to primary work location, such as complexity and responsibility of role, job duties/requirements, and relevant experience and skills. Base pay ranges are reviewed and typically updated each year. Offers are made within the base pay range applicable at the time.
Minimum Salary/Wage
USD$ 15.00 Hr.
Maximum Salary/Wage
USD$ 23.50 Hr.

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