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Prior Authorization Jobs in Virginia (NOW HIRING)

Riverside Health System Non-Providers

$23.90 - $31.10/hr

Follows prior authorization and/or patient assistance workflows and policies/procedures. * Demonstrates the ability to work independently, meet deadlines and possesses excellent time management ...

Riverside

$23.90 - $31.10/hr

Follows prior authorization and/or patient assistance workflows and policies/procedures. * Demonstrates the ability to work independently, meet deadlines and possesses excellent time management ...

Integrated Resources INC

Pharmacy Technician

Glen Allen, VA · On-site

$16.50 - $20/hr

Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria. ESSENTIAL FUNCTIONS:- Determines ...

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All JobsPrior Authorization JobsPrior Authorization Jobs in Virginia

Prior Authorization information

See Virginia salary details

$13

$20

$31

How much do prior authorization jobs pay per hour?

As of Jun 28, 2026, the average hourly pay for prior authorization in Virginia is $20.71, according to ZipRecruiter salary data. Most workers in this role earn between $17.16 and $22.88 per hour, depending on experience, location, and employer.

How much do precertification specialists make?

Precertification specialists typically earn a median annual salary between $40,000 and $55,000, depending on experience, location, and employer. They often require knowledge of insurance policies and medical billing software, with some roles offering additional certifications to increase earning potential.

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 does a prior authorization job do?

A prior authorization specialist reviews and processes requests for approval of medical procedures, medications, or treatments from insurance companies. They verify patient information, ensure documentation is complete, and communicate with healthcare providers and insurers to obtain necessary approvals, often using electronic health record systems. This role helps ensure that necessary care is authorized while complying with insurance policies.

What job makes $10,000 a month without a degree?

High-paying jobs that can reach $10,000 a month without a degree include roles like sales managers, real estate brokers, or certain skilled trades such as electricians or plumbers, especially with experience and certifications. These positions often require strong skills, industry knowledge, and sometimes licensing, but not necessarily a college degree.

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 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 Virginia? The most popular types of Prior Authorization jobs in Virginia are:
What are popular job titles related to Prior Authorization jobs in Virginia? For Prior Authorization jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Prior Authorization jobs in Virginia look for? The top searched job categories for Prior Authorization jobs in Virginia are:
What cities in Virginia are hiring for Prior Authorization jobs? Cities in Virginia with the most Prior Authorization job openings:
Prior Authorization jobs near you
Infographic showing various Prior Authorization job openings in Virginia as of June 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $43,087 per year, or $20.7 per hour.
Prior Authorization Clerk

Prior Authorization Clerk

Healthcare Support Staffing

Richmond, VA • On-site

$17 - $21.75/hr

Other

Posted 28 days ago

Job description

Company Description

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!

Job Description

Working in medical call center to handle requests for authorizations. 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 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. 


Qualifications

HS Diploma or GED 

1 year relevant experience

Strong analytical, written and oral communication

Knowledge of medical terminology a must


Additional Information

Hours for this Position:

M-F 8:30am-5pm


Want More Information? 

Interested in hearing more about this great opportunity? Reach out to Stephanie Zymowski at 407-636-7030 ext220 for immediate consideration. 

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About Healthcare Support

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.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Maitland, FL, US

Year founded

2003

Social media

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