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Prior Authorization Jobs in Iowa (NOW HIRING)

DMOS

Patient Navigator - Prior Auth

West Des Moines, IA

$18.25 - $25/hr

The department will initially focus on inpatient surgery prior authorization to kick off the team. In this full-time position you will work alongside your current team of navigators to help ...

DMOS

Patient Navigator - Prior Auth

West Des Moines, IA · On-site

$19.75 - $27/hr

The department will initially focus on inpatient surgery prior authorization to kick off the team. In this full-time position you will work alongside your current team of navigators to help ...

DMOS

Patient Navigator - Prior Auth

West Des Moines, IA · On-site

$18.25 - $25/hr

The department will initially focus on inpatient surgery prior authorization to kick off the team. In this full-time position you will work alongside your current team of navigators to help ...

Actalent

Pharmacy Technician

Des Moines, IA · On-site

$17 - $20.75/hr

Assign, enter, and document prior authorizations into the appropriate claims processing system. * Answer phone calls regarding prior authorization inquiries and provide clear, accurate information.

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All JobsPrior Authorization JobsPrior Authorization Jobs in Iowa

Prior Authorization information

See Iowa salary details

$12

$19

$30

How much do prior authorization jobs pay per hour?

As of Sep 8, 2026, the average hourly pay for prior authorization in Iowa is $19.62, according to ZipRecruiter salary data. Most workers in this role earn between $16.25 and $21.68 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 Iowa?

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

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

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

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

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

What cities in Iowa are hiring for Prior Authorization jobs?

Cities in Iowa with the most Prior Authorization job openings:

Prior Authorization jobs near you
Infographic showing various Prior Authorization job openings in Iowa as of September 2026, with employment types broken down into 83% Full Time, and 17% Part Time. Highlights an 100% In-person job distribution, with an average salary of $40,820 per year, or $19.6 per hour.

Prior Authorization Nurse

Fairfield, IA • On-site

Jefferson County Health Center
Health Care and Social Assistance • 201 - 500 employees
Learn more about Jefferson County Health Centerexternal

Full-time

This job post has expired today. Applications are no longer accepted.

Key responsibilities

  • Review clinical documentation to determine medical necessity for requested services.

  • Submit prior authorization requests to insurance companies using payer-specific portals and Epic workflows.

  • Track and follow up on pending authorizations to ensure timely responses.

Jefferson County Health Center rating

9.1

Company rating: 9.1 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

14th of 1,066 rated hospitals

Job description

POSITION OVERVIEW (non-exempt):

The Prior Authorization Nurse plays a critical role in ensuring timely and accurate authorization of medical services across multiple specialties. This position serves as a liaison between providers, patients, and insurance companies to facilitate timely access to care while ensuring compliance with payer guidelines. The nurse utilizes clinical knowledge and judgment to evaluate medical necessity, gather supporting documentation, verifying insurance requirements and submitting prior authorization requests for multiple specialties. Working collaboratively with physicians, clerical staff, and other departments, the Prior Authorization Nurse helps streamline workflows, reduce delays in care, and optimize reimbursement.

QUALIFICATIONS:

  • Current Registered Nurse (RN) license in IA preferred. Licensed Practical Nurse (LPN) applicants with relevant prior authorization experience will also be considered
  • 2+ years of clinical nursing experience
  • Prior experience in utilization review, case management, or prior authorization preferred
  • Strong knowledge of payer policies and clinical criteria (e.g., InterQual, MCG)
  • Experience in one or more of the following specialties: oncology, radiology, infusion therapy, pain management procedures or surgical services
  • Experience with Microsoft Office, Excel and other web-based programs including CoverMyMeds
  • Excellent communication, organizational and time management skills

ACCOUNTABILITY: 

Reports to the Prior Authorization Manager and Revenue Cycle Director

DIRECT REPORTS:

None

POSITION-SPECIFIC REQUIREMENTS:

  • Review clinical documentation to determine medical necessity for requested services.
  • Submit prior authorization requests to insurance companies using payer-specific portals and Epic workflows.
  • Communicate with providers to obtain additional documentation or clarify orders as needed.
  • Track and follow up on pending authorizations to ensure timely responses.
  • Document all authorization activity in the electronic health record (Epic).
  • Collaborate with other team members to ensure complete and accurate submissions.
  • Stay current with payer guidelines, authorization requirements, and regulatory changes.
  • Escalate denials or delays to appropriate clinical or administrative leadership.
  • Coordinate and schedule peer-to-peer (P2P) reviews between providers and payers to address clinical denials.
  • Submit formal appeals for denied services, ensuring compliance with payer-specific guidelines and timelines
  • Participate in process improvement initiatives to streamline authorization workflows.
  • Perform additional responsibilities as requested by leadership to support departmental goals and hospital operations

WORK ENVIRONMENT:

  • Works in a well-illuminated, climate-controlled environment
  • May come in contact with hazardous chemical or treatment modalities
  • Possibility exists of exposure to communicable diseases
  • Involvement in inpatient care may result in unavoidable work-related illness or injury
  • Work environment is comfortable, with minimal exposure to physical hazards
  • Moderate to loud noise environment when machines/equipment in use
  • Involvement in checking in/moving of supplies may result in unavoidable work-related injury
  • Must be constantly alert for patient/family emergency situations

What Jefferson County Health Center employees say

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