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Prior Authorization Jobs in Florida (NOW HIRING)

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$24

How much do prior authorization jobs pay per hour?

As of Aug 26, 2026, the average hourly pay for prior authorization in Florida is $15.61, according to ZipRecruiter salary data. Most workers in this role earn between $12.93 and $17.26 per hour, depending on experience, location, and employer.

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.

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, along with knowledge of medical billing and coding. Relevant skills include attention to detail, communication, and familiarity with insurance policies and electronic health record systems. Certification in medical billing or coding can enhance job prospects.

What career paths follow prior authorization?

Careers following prior authorization 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 certifications like CPC or CCS. Advancement can lead to supervisory or managerial roles within healthcare administration or insurance companies.

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.
More about Prior Authorization jobs

What are the most commonly searched types of Prior Authorization jobs in Florida?

The most popular types of Prior Authorization jobs in Florida are:

What are popular job titles related to Prior Authorization jobs in Florida?

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

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

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

What cities in Florida are hiring for Prior Authorization jobs?

Cities in Florida with the most Prior Authorization job openings:

Prior Authorization jobs near you
Infographic showing various Prior Authorization job openings in Florida as of August 2026, with employment types broken down into 50% Full Time, and 50% Contract. Highlights an 100% In-person job distribution, with an average salary of $32,477 per year, or $15.6 per hour.

Referral and Prior Authorization Specialist

Melbourne, FL • On-site

Suntree Internal Medicine
Outpatient Health Care • 51 - 200 employees
Learn more about Suntree Internal Medicineexternal

$85/hr

Other

Retirement, PTO

Posted 7 days ago

Job description

Medical Referral And Prior Authorization Specialist

Position - Medical Referral and Prior Authorization Specialist - FLSA Status - Hourly Non-Exempt

Reports to - Documents Manager - Shift - 8 hour shifts (varies)

Wage: $15.00- $16.00 per hour

Education:

  • High School Diploma or GED required
  • Medical Terminology Knowledge required
  • Medical Experience preferred

Responsibilities:

  • Process referral requests made by providers.
  • Gather medication information: quantity, diagnosis, dosages, directions
  • Gather patients current insurance information
  • Ensure accuracy of forms and clinical questions per insurance company
  • Utilize the covermymeds system for medication prior authorizations and keeping the requests cleaned up.
  • Enter requests into the DASH system and compile referrals and records to be sent to the specialist office ensuring that the provider we send a patient to accepts the insurance the patient has..
  • Communicate with the patientsthe status of any referrals or prior authorizations sent on a patient's behalf.
  • Obtain authorizations as required for patients to see specialists or procedures that they ordered as necessary.
  • Work on lab rebills as needed.
  • Transmit information or documents to customers, using a computer, mail, or facsimile machine.
  • Analyze data to determine answers to questions from patients.

Abilities:

  • High-level of multi-tasking
  • Time management skills
  • Medical Terminology
  • Team player
  • Follow step-by-step procedures
  • Personable

Physical Requirements:

  • Requires full range of body motion including handling and lifting of patients, manual and finger dexterity, and hand-eye coordination.
  • Requires standing and walking for extensive periods of time
  • Occasionally lifts and carries items weighing up to fifty (50) pounds
  • Requires corrected vision, hearing, and speech within normal ranges
  • Requires working under stressful conditions and sometimes irregular hours
  • Potential contact with bloodborne pathogens, bodily secretions, etc.

Background Screening Requirements:

  • You must pass a level 2 background screening PRIOR to joining Suntree Internal Medicine. If you have have one done and do not have one on file, after 90 days of employment Suntree Internal Medicine will reimburse you for this up to $85.00. Please provide your receipt to HR on your first day.

About Suntree Internal Medicine:

We are a large private internal medicine practice located in Melbourne, Florida. We are an equal opportunity employer and we believe that education and training are a key part of success. Our values are to bring Sincerity, Inspiration, and Mastery into the workplace. We offer benefits, paid time off, 401K and holidays after the 90-day probation period review.

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