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Prior Authorization Jobs in Virginia (NOW HIRING)

Summit BHC

Intake RN-PRN

Williamsburg, VA · On-site

$45 - $50/hr

Facilitates intake, admission, and prior authorization process for incoming patients. * Performs insurance benefit verifications, disseminating the information gathered to patients, their families ...

Pavilion

Intake RN-PRN

Williamsburg, VA · On-site

Facilitates intake, admission, and prior authorization process for incoming patients.* Performs insurance benefit verifications, disseminating the information gathered to patients, their families ...

New

Amazon

Sr. Specialist, Work Authorization

Arlington, VA · On-site

$20.75 - $27.50/hr

Work Authorization program. This team ensures all Amazon employees are legally authorized to work and remain authorized throughout their employment, mitigating risks of non-compliance, financial ...

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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 Sep 4, 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.

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 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 August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 18% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $43,087 per year, or $20.7 per hour.

Assessment & Authorization Specialist

J5 Consulting

Herndon, VA • On-site

$18.50 - $24.75/hr

Full-time

Medical, Retirement, PTO

Re-posted 24 days ago

Job description

J5 Consulting is a Maryland based company established in 2006 to provide computing and consulting services for government and commercial entities. Our services improve Information System networking performance and compliance and protect electronic assets from loss and compromise. We welcome your application to receive consideration for the following position.

Introduction:

The Sponsor’s organization provides technical services to other Sponsor organizations in the areas of:
• Desktop hardware to include workstations, printers, multi-function devices, monitors, desktop peripherals, large displays, webcams, and a variety of other hardware devices.
• Voice to include networks, VoIP, analog, and digital implementations.
• Audio and video to include desktop VTC, integrated audio and video conference room setups (cameras, speakers, A/V switches, control panels, etc.), and multi-VTC integrated room setups.
The Contractor shall be required to provide Certification and Accreditation support to advise and assist the stakeholders with the Lifecycle Assessment and Authorization (A&A) process, and develop a Systems Security Plan (SSP). 
 

Required skills and demonstrated experience:
 

  • Bachelor’s degree in management information systems, information assurance, computer engineering, or other closely related IT and cybersecurity discipline or equivalent work experience
  • Demonstrated experience in the Risk Management Framework (RMF) methodology.
  • Demonstrated experience managing document repositories and databases.
  • Demonstrated experience in the use of process tracking and document control software
  • Demonstrated experience with writing, communications, and briefing skills.
  • Demonstrated experience with technical guidance and oversight both to technical and non-technical, senior level personnel.
  • Demonstrated experience organizing, planning and prioritizing multiple tasks to complete work on schedule.
  • Demonstrated experience in INFOSEC policies, regulations, and guidance’s.
  • Demonstrated experience with cyber risks such as malware, zero-day attacks, denial of service attacks, as well as associated mitigations regarding computer and network devices.
  • Demonstrated pattern of excellent customer service skills and the ability to collaborate with customers at all levels.

Highly desired, though not required, include:
 

  • Demonstrated experience with the Sponsor’s A&A process.
  • Certified Information Systems Security Professional (CISSP).
  • Demonstrated knowledge of the Sponsor’s standard project cycle.
  • Demonstrated experience with the Sponsor’s diverse information technology infrastructure, including operating systems, major application systems, and network architecture.

__________________________________________________________________________________

US Citizenship:

  • This position requires US Citizenship. Verification of US Citizenship to meet federal government security requirements will be confirmed.

Security Clearance:

  • The successful candidate must have an active U.S. Government Top Secret Security Clearance with a Full Scope Polygraph.
  • Clearance Verification: This position requires successful verification of the stated security clearance to meet federal government customer requirements. You will be asked to provide clearance verification information prior to an offer of employment.

Travel:

  •  This position is expected to be onsite. The position will be located within the Washington Metropolitan Area (WMA).   Local travel/POV will be on an as needed basis, within the local place of performance.

 

Join J5 Consulting and Grow Your Cybersecurity Career

At J5, we’re a team of innovators protecting organizations from evolving cyber threats. With 18+ years of success in government and commercial sectors, we offer meaningful opportunities to grow your career.

Enjoy comprehensive benefits, including:

  • 100% employer-paid health coverage
  • a 6% 401(k) match
  • PTO
  • tuition reimbursement
  • bonuses
  • professional development, and more.

Ready to make an impact? Explore our open positions and apply today.

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