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Prior Authorization Jobs in Minnesota (NOW HIRING)

RXinsider LTD.

VP Product Innovation

Minneapolis, MN · On-site

$282 - $345/hr

Job Summary The VP Product Innovation - Prior Authorization creates and oversees the product strategy, Go-To-Market planning, product roadmap, and lifecycle of an assigned solution portfolio ...

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Minnesota Jobs

RN Pre-Service Authorization

Duluth, MN · On-site

Works collaboratively with and provides clinical expertise and leadership to Access Coordinators to perform all aspects of managed care, including the referral, prior authorization/precertification ...

Insight Global

Pharmacist

Minneapolis, MN · On-site

$59/hr

The Pharmacist, Prior Authorization (PA) & Appeals, is responsible for reviewing and evaluating prior authorization and appeals requests to determine coverage based on clinical guidelines, pharmacy ...

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Prior Authorization information

See Minnesota salary details

$13

$20

$31

How much do prior authorization jobs pay per hour?

As of Aug 15, 2026, the average hourly pay for prior authorization in Minnesota is $20.46, according to ZipRecruiter salary data. Most workers in this role earn between $16.97 and $22.60 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.
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Prior Authorization jobs near you
Infographic showing various Prior Authorization job openings in Minnesota as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 14% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $42,565 per year, or $20.5 per hour.

SUD IOP Authorization and Back Up Residential Cycle Specialist

Nystrom & Associates Ltd

Arden Hills, MN • Remote

$23 - $25/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 25 days ago

Nystrom & Associates rating

7.4

Company rating: 7.4 out of 10

Based on 22 frontline employees who took The Breakroom Quiz

Job description

Location: 1200 County Road E., Arden Hills, MN 55112

Working Model: Remote

Employee Type: 1.0 FTE

Schedule: Flexible 8 hour shift worked between 6:00 AM and 6:00 PM

AtSagentBehavioral Health, we believe profound change is possible. As one of the largest behavioral health organizations in the Midwest-with 2,000+ team members across 80+ locations in five states-we offer the stability and resources to help you thrive.
Backed by more than 100 years of combined behavioral health experience,Sagentbrings together the trusted legacies of Ellie Mental Health, LifeWorks, Nystrom & Associates, Psychiatric Associates, Sandhill Counseling & Consultation, and Vantage Point.
Here,you'llfind a supportive, inclusive culture where you can hone your skills, collaborate with a fantastic team, and build a rewarding career focused on what matters most: helping others find hope. Guided by our HOPE values-Humility, Optimism, People-Centered, and Ethical Practice-we provide manageable caseloads, flexible schedules, and compensation options that work for you-from salary to production-based models.

As a SUD RESIDENTAL REVENUE CYCLE SPECIALIST atSagent Behavioral Health, you will manage and optimize revenue-related processes for residential accounts. This role ensures obtaining appropriate prior authorizations, accurate billing, timely collections, accurate and timely payment posting to maximize financial performance.

Full Time Benefits:

  • Medical, Dental, Vision

  • 401k, Long Term Disability, Short Term Disability and Life Insurance

PTO and Time Off

Responsibilities:

  • Research, reconcile and resolve billing discrepancies and payment issues with payors
  • Posting payments in a timely and accurate manner
  • Professional and timely communication with providers and business office staff
  • Attend and participate in monthly staff meetings and any other meetings and/or training sessions as indicated
  • Back up for the end-to-end residential revenue cycle, including account setup, obtaining authorizations, billing, payment posting and collections
  • Field/ resolve provider and clinic inquiries via email or task ensuring inquiries are followed up on within 24 hours of creation
  • Point person for Intensive Outpatient Program extensions and changes
  • Obtain, track, and follow up on initial SUD authorizations/Referrals for Intensive Outpatient Program

Requirements:

  • Previous experience working with IOP SUD or Residential revenue cycle
  • Minimum of two years working in health care residential or SUD IOP facilities preferred, particularly with billing, authorizations and unpaid claims
  • Familiarity with insurance company guidelines and HIPAA regulations

Compensation: $23.00 - $25.00/hr

*Actual compensation may bedeterminedbyvarious factorssuch as education, experience, skillset, internal equity,scheduleand/or location.

* Employees in these positions are W2.

SagentBehavioral Health is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

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