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Prior Authorization Jobs in Ohio (NOW HIRING)

Equitas Health

Prior Authorization Specialist

Columbus, OH · On-site

$18.13 - $21.78/hr

The Prior Authorization Specialist handles all prior authorizations, third party appeals, and pending third party payer issues across all Equitas Health medical centers. This individual will work ...

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Prior Authorization information

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$13

$19

$30

How much do prior authorization jobs pay per hour?

As of Jul 29, 2026, the average hourly pay for prior authorization in Ohio is $19.86, according to ZipRecruiter salary data. Most workers in this role earn between $16.44 and $21.92 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 Ohio? The most popular types of Prior Authorization jobs in Ohio are:
What are popular job titles related to Prior Authorization jobs in Ohio? For Prior Authorization jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Prior Authorization jobs in Ohio look for? The top searched job categories for Prior Authorization jobs in Ohio are:
What cities in Ohio are hiring for Prior Authorization jobs? Cities in Ohio with the most Prior Authorization job openings:
Prior Authorization jobs near you
Infographic showing various Prior Authorization job openings in Ohio as of July 2026, with employment types broken down into 1% As Needed, 85% Full Time, 12% Part Time, and 2% Contract. Highlights an 93% Physical, 3% Hybrid, and 4% Remote job distribution, with an average salary of $41,317 per year, or $19.9 per hour.

Prior Authorization Specialist

Equitas Health, Inc.

Columbus, OH

$18.13 - $21.78/hr

Full-time

Posted 16 days ago

Equitas Health rating

5.4

Company rating: 5.4 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

Job description

ORGANIZATION INFORMATION:

Established in 1984, Equitas Health is a regional not-for-profit community-based healthcare system and federally qualified community health center look-alike. Its expanded mission has made it one of the nation’s largest HIV/AIDS, lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) healthcare organizations. With 22 offices in 12 cities, it serves more than 67,000 individuals in Ohio, Kentucky, and West Virginia each year through its diverse healthcare and social service delivery system focused around: primary and specialized medical care, retail pharmacy, dental, behavioral health, HIV/STI prevention, advocacy, and community health initiatives.

HOURLY RATE: $18.13-$21.78

BENEFITS:
  • PTO
  • Vision
  • Dental
  • Health
  • 401k
  • Sick time

POSITION SUMMARY:
The Prior Authorization Specialist handles all prior authorizations, third party appeals, and pending third party payer issues across all Equitas Health medical centers. This individual will work with internal and external pharmacies, CoverMyMeds, the EHR, and all Equitas Health health center providers to facilitate prior authorization completion. This individual must be able to work in conjunction with the pharmacy department and health center staff to facilitate the prior authorization process.
ESSENTIAL JOB FUNCTIONS:
The Prior Authorization Specialist is responsible for handling all prior authorizations, appeals, and third party medication disputes for providers at Equitas Health. The Prior Authorization Specialist will be required to communicate with prescribers, pend medication changes, and maintain exceptional documentation in the patient health record. The staff member will also be in constant communication with internal pharmacies, external pharmacies, and patients waiting on prior authorizations. Essential job functions include, but are not limited to, driving or having reliable transportation, written and verbal communication, utilizing a computer for typing, multi-system use/maintenance, and attending meetings.
MAJOR AREAS OF RESPONSIBILITIES:

  • Complete prior authorizations submission within established time frame.
  • Collaborate with providers to manage appeals and/or peer-to-peer discussion with third party representatives.
  • Ensure proper documentation is maintained in the EHR.
  • Work with clinical pharmacist team to provide potential therapeutic substitutions to prescribers
  • Communicate with the clinical team on the status of prior authorizations or changes that must be made for therapy to continue for the patient.
  • Maintain constant communication with the internal and external pharmacy teams for medication processing.
  • Inform patients when prior authorizations are approved.
  • Provide data on prior authorizations as needed to Senior Leadership.
  • Other duties as assigned by the Prior Authorization Supervisor, Director of Nursing, and Leadership.
  • Comply with the Equitas Health Care Corporate Compliance Standards of Conduct and related policies and procedures.
  • Demonstrate unconditional positive regard to clients and conduct all aspects of job responsibilities.
  • Continuously grow and develop cultural competency, exhibiting an understanding, awareness, and respect for diversity.
  • Contribute to a positive work environment by demonstrating unconditional positive regard to all Equitas Health employees, interns, etc. with an understanding, awareness, and respect for diversity.


EDUCATION/LICENSURE:

  • Medical Assistant, Certified Pharmacy Technician or Registered Pharmacy Technician (must be registered with State of Ohio Board of Pharmacy).


Knowledge, Skills, Abilities and other Qualifications:

  • Experience working in medical records preferred.
  • Must be able to accurately and effectively meet established deadlines
  • Experience with prior authorizations preferred.
  • Strong attention to detail.
  • Ability to be flexible in working hours.
  • Must ensure detailed and thorough documentation.
  • Exemplary written and verbal communication skills.
  • Knowledge of healthcare terminology.
  • Must have sensitivity to, interest in and competence in cultural differences, HIV/AIDS, minority health, sexual practices, chemical dependency and a demonstrated competence in working with persons of color, and gay/lesbian/bisexual/transgender community.
  • Proficiency in all Microsoft Office applications, computers, email, web-based systems and electronic health records.
  • Reliable transportation, driver’s license and proof of auto insurance required.

OTHER INFORMATION:

Background and reference checks will be conducted. In accordance with Equitas Health’s Drug-Free Workplace Policy, pre-employment drug testing will be administered. Hours may vary, including working some evenings and weekends based on workload. Individuals are not considered applicants until they have been asked to visit for an interview and at that time complete an application for employment. Completing the application does not guarantee employment. EOE/AA

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