Prior Authorization Clerk
$17 - $21.75/hr
Coordinating cases for precertification and prior authorization review Daily Responsibilities: Managing incoming calls or incoming post services claims work ID and data entry of referral requests ...
$17 - $21.75/hr
Coordinating cases for precertification and prior authorization review Daily Responsibilities: Managing incoming calls or incoming post services claims work ID and data entry of referral requests ...
$17 - $21.75/hr
Coordinating cases for precertification and prior authorization review Daily Responsibilities: Managing incoming calls or incoming post services claims work ID and data entry of referral requests ...
$48K - $63K/yr
Position Summary The Prior Authorization Technician will process prior authorizations and locate foundation assistance for GW Medical Faculty Associates providers. Essential Duties and ...
$48K - $63K/yr
Position Summary The Prior Authorization Technician will process prior authorizations and locate foundation assistance for GW Medical Faculty Associates providers. Essential Duties and ...
Arlington, VA · On-site
$23.46 - $30.50/hr
Position Summary The Prior Authorization Technician will process prior authorizations and locate foundation assistance for GW Medical Faculty Associates providers. Essential Duties and ...
Arlington, VA · On-site
$23.46 - $30.50/hr
Position Summary The Prior Authorization Technician will process prior authorizations and locate foundation assistance for GW Medical Faculty Associates providers. Essential Duties and ...
$48K - $63K/yr
Position Summary The Prior Authorization Technician will process prior authorizations and locate foundation assistance for GW Medical Faculty Associates providers. Essential Duties and ...
$48K - $63K/yr
Position Summary The Prior Authorization Technician will process prior authorizations and locate foundation assistance for GW Medical Faculty Associates providers. Essential Duties and ...
Arlington, VA · On-site
$23.46 - $30.50/hr
Position Summary The Prior Authorization Technician will process prior authorizations and locate foundation assistance for GW Medical Faculty Associates providers. Essential Duties and ...
Arlington, VA · On-site
$23.46 - $30.50/hr
Position Summary The Prior Authorization Technician will process prior authorizations and locate foundation assistance for GW Medical Faculty Associates providers. Essential Duties and ...
Virginia Beach, VA · On-site +1
$17.75 - $23.25/hr
Sentara Health Plans is looking to hire Pharmacy Prior Authorization Coordinator 1: This is a remote position: Remote opportunities available in the following states: Virginia, North Carolina ...
Virginia Beach, VA · On-site +1
$17.75 - $23.25/hr
Sentara Health Plans is looking to hire Pharmacy Prior Authorization Coordinator 1: This is a remote position: Remote opportunities available in the following states: Virginia, North Carolina ...
Reston, VA · On-site
$23/hr
This role is responsible for obtaining prior authorization for various medical procedures, services, and medications. This is a full-time position working out of our Reston office. The position ...
Reston, VA · On-site
$23/hr
This role is responsible for obtaining prior authorization for various medical procedures, services, and medications. This is a full-time position working out of our Reston office. The position ...
$19 - $25.25/hr
This role is responsible for obtaining prior authorization for various medical procedures, services, and medications. This is a full-time position working out of our Reston office. The position ...
$19 - $25.25/hr
This role is responsible for obtaining prior authorization for various medical procedures, services, and medications. This is a full-time position working out of our Reston office. The position ...
Reston, VA · On-site
$18.75 - $25/hr
This role is responsible for obtaining prior authorization for various medical procedures, services, and medications. This is a full-time position working out of our Reston office. The position ...
Reston, VA · On-site
$18.75 - $25/hr
This role is responsible for obtaining prior authorization for various medical procedures, services, and medications. This is a full-time position working out of our Reston office. The position ...
Reston, VA · On-site
$18.75 - $25/hr
This role is responsible for obtaining prior authorization for various medical procedures, services, and medications. This is a full-time position working out of our Reston office. The position ...
Reston, VA · On-site
$18.75 - $25/hr
This role is responsible for obtaining prior authorization for various medical procedures, services, and medications. This is a full-time position working out of our Reston office. The position ...
Reston, VA · On-site
This role is responsible for obtaining prior authorization for various medical procedures, services, and medications. This is a full-time position working out of our Reston office. The position ...
Quick apply
Reston, VA · On-site
This role is responsible for obtaining prior authorization for various medical procedures, services, and medications. This is a full-time position working out of our Reston office. The position ...
Chantilly, VA · On-site
$17.50 - $21.75/hr
Identifies out-of-pocket co-pays, deductibles, and co-insurance prior to services rendered in ... Processes Prior Authorizations via Fax, computer or phone call as required by the specific payers.
Quick apply
Chantilly, VA · On-site
$17.50 - $21.75/hr
Identifies out-of-pocket co-pays, deductibles, and co-insurance prior to services rendered in ... Processes Prior Authorizations via Fax, computer or phone call as required by the specific payers.
The ideal candidate will have experience in prior authorizations, insurance verification, utilization review, and medical necessity determinations. This role is responsible for ensuring that medical ...
Quick apply
The ideal candidate will have experience in prior authorizations, insurance verification, utilization review, and medical necessity determinations. This role is responsible for ensuring that medical ...
Richmond, VA · On-site
$27 - $31/hr
The ideal candidate will have experience in prior authorizations, insurance verification, utilization review, and medical necessity determinations. This role is responsible for ensuring that medical ...
Richmond, VA · On-site
$27 - $31/hr
The ideal candidate will have experience in prior authorizations, insurance verification, utilization review, and medical necessity determinations. This role is responsible for ensuring that medical ...
Manassas, VA · On-site
$17.31 - $33.28/hr
This position will perform prior authorization for advance medical imaging, including CT, MRI and PET scans. These jobs focus on managing the financial aspects of patient care, including billing ...
Manassas, VA · On-site
$17.31 - $33.28/hr
This position will perform prior authorization for advance medical imaging, including CT, MRI and PET scans. These jobs focus on managing the financial aspects of patient care, including billing ...
$23.90 - $31.10/hr
Overview Supports patient access to specialty medications by coordinating prior authorizations, benefit investigations, and patient assistance programs under the supervision of a licensed pharmacist ...
$23.90 - $31.10/hr
Overview Supports patient access to specialty medications by coordinating prior authorizations, benefit investigations, and patient assistance programs under the supervision of a licensed pharmacist ...
$23.90 - $31.10/hr
Overview Supports patient access to specialty medications by coordinating prior authorizations, benefit investigations, and patient assistance programs under the supervision of a licensed pharmacist ...
New
$23.90 - $31.10/hr
Overview Supports patient access to specialty medications by coordinating prior authorizations, benefit investigations, and patient assistance programs under the supervision of a licensed pharmacist ...
New
$23.90 - $31.10/hr
Overview Supports patient access to specialty medications by coordinating prior authorizations, benefit investigations, and patient assistance programs under the supervision of a licensed pharmacist ...
$23.90 - $31.10/hr
Overview Supports patient access to specialty medications by coordinating prior authorizations, benefit investigations, and patient assistance programs under the supervision of a licensed pharmacist ...
Newport News, VA · On-site
$23.90 - $31.10/hr
Overview Supports patient access to specialty medications by coordinating prior authorizations, benefit investigations, and patient assistance programs under the supervision of a licensed pharmacist ...
Newport News, VA · On-site
$23.90 - $31.10/hr
Overview Supports patient access to specialty medications by coordinating prior authorizations, benefit investigations, and patient assistance programs under the supervision of a licensed pharmacist ...
Newport News, VA · On-site
$23.90 - $31.10/hr
Overview Supports patient access to specialty medications by coordinating prior authorizations, benefit investigations, and patient assistance programs under the supervision of a licensed pharmacist ...
New
Newport News, VA · On-site
$23.90 - $31.10/hr
Overview Supports patient access to specialty medications by coordinating prior authorizations, benefit investigations, and patient assistance programs under the supervision of a licensed pharmacist ...
New
$13.58 - $15.25
6% of jobs
$15.25 - $16.92
14% of jobs
$17.34 is the 25th percentile. Wages below this are outliers.
$16.92 - $18.59
20% of jobs
The median wage is $19.52 / hr.
$18.59 - $20.26
18% of jobs
$20.26 - $21.93
16% of jobs
$22.12 is the 75th percentile. Wages above this are outliers.
$21.93 - $23.59
12% of jobs
$23.59 - $25.26
7% of jobs
$25.26 - $26.93
5% of jobs
$26.93 - $28.60
2% of jobs
$28.60 - $30.27
0% of jobs
$30.27 - $31.94
0% of jobs
$13
$20
$31
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.
| Aspect | Prior Authorization | Medical Billing Specialist |
|---|---|---|
| Credentials | Typically requires knowledge of insurance policies, healthcare regulations, and sometimes certifications like NCQA or AHIP | Requires knowledge of coding, billing procedures, and often certifications like CPC or CCS |
| Work Environment | Healthcare provider offices, insurance companies, or hospitals | Medical offices, billing companies, or healthcare facilities |
| Employer & Industry Usage | Used by healthcare providers and insurers to approve treatments or procedures | Used 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.

$17 - $21.75/hr
Other
Posted 26 days ago
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Working in medical call center to handle requests for authorizations. Coordinating cases for precertification and prior authorization review
Daily Responsibilities: Â
Managing incoming calls or incoming post services claims work
ID and data entry of referral requests into the UM system in accordance with the plan certificate
Respond to telephone and written inquiries from clients, providers and in house departments.
Determine contract and benefit eligibility
Provide authorization for inpatient admission, outpatient precertification, prior authorization and post services requests.Â
HS Diploma or GEDÂ
1 year relevant experience
Strong analytical, written and oral communication
Knowledge of medical terminology a must
Hours for this Position:
M-F 8:30am-5pm
Want More Information?Â
Interested in hearing more about this great opportunity? Reach out to Stephanie Zymowski at 407-636-7030 ext220 for immediate consideration.Â
Sourced by ZipRecruiter
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
Recruiting and staffing services
201 - 500 Employees
Maitland, FL, US
2003