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Prior Authorization Jobs in Athens, GA (NOW HIRING)

MC-Rx

Prior Authorization Coordinator

Gainesville, GA · On-site

$21 - $23/hr

Manage the full lifecycle of prior authorization (PA) requests in support of manufacturer-sponsored patient support programs, utilizing payer portals, electronic submission platforms, fax, and ...

MC-Rx

Prior Authorization Coordinator

Gainesville, GA · On-site

$21 - $23/hr

Manage the full lifecycle of prior authorization (PA) requests in support of manufacturer-sponsored patient support programs, utilizing payer portals, electronic submission platforms, fax, and ...

Avery Partners

Medical Assistant

Buckhead, GA

$20 - $26/hr

Handle prior authorizations * knowledge of sterile technique and wound care * instrument cleaning/sterilization care * Document visit * schedule appointments * stock rooms with supplies * general ...

Dermatology Solutions Group

Medical Assistant

Royston, GA · On-site

$15.25 - $19.50/hr

Performs medication prior authorizations as necessary. * Responsible for abiding by the Standards of Conduct and meets all compliance and other training requirements. * Participates in professional ...

Dermatology Solutions Group

Medical Assistant

Royston, GA · On-site

$15.25 - $19.50/hr

Performs medication prior authorizations as necessary. * Responsible for abiding by the Standards of Conduct and meets all compliance and other training requirements. * Participates in professional ...

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Prior Authorization information

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How much do prior authorization jobs pay per hour?

As of Sep 5, 2026, the average hourly pay for prior authorization in Athens, GA is $20.18, according to ZipRecruiter salary data. Most workers in this role earn between $16.73 and $22.26 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.
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The most popular types of Prior Authorization jobs in Athens, GA are:

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Cities near Athens, GA with the most Prior Authorization job openings:

Prior Authorization jobs near you
Infographic showing various Prior Authorization job openings in Athens, GA as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 19% Part Time, 1% Temporary, and 3% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $41,964 per year, or $20.2 per hour.

Prior Authorization Coordinator

Burgess Information Systems, Inc.

Gainesville, GA • On-site

$21 - $23/hr

Full-time

This job post has expired today. Applications are no longer accepted.

Key responsibilities

  • Manage the full lifecycle of prior authorization requests using payer portals, electronic platforms, fax, and telephonic outreach.

  • Serve as a central point of coordination between prescribers, pharmacies, payers, and internal teams to facilitate authorization approval and therapy initiation.

  • Conduct benefits verification and coverage analysis, initiate and track prior authorization submissions, and follow up with payers to expedite determinations.

Job description

Status:  Hourly, Non-Exempt

Hourly Rate: $21.00 - $23.00

Location:  Onsite, Gainesville, GA 

JOB RESPONSIBILITIES

  • Manage the full lifecycle of prior authorization (PA) requests in support of manufacturer-sponsored patient support programs, utilizing payer portals, electronic submission platforms, fax, and telephonic outreach to facilitate timely access to therapy.
  • Serve as a central coordination point between prescribers, specialty pharmacies, payers, and internal HUB teams to ensure seamless progression from benefits investigation through authorization approval and therapy initiation.
  • Conduct comprehensive benefits verification and coverage analysis to identify prior authorization requirements, payer restrictions, and potential access barriers; initiate and track PA submissions accordingly.
  • Submit accurate and complete prior authorization requests, including all required clinical documentation, and perform proactive follow-up with payers to expedite determinations and minimize delays in therapy access.
  • Partner closely with provider offices to obtain clinical information, clarify prescribing intent, and support the development and submission of first-level appeals, reconsiderations, and medical exception requests.
  • Collaborate cross-functionally with HUB teams including reimbursement, copay assistance, patient assistance programs (PAP), and specialty pharmacy partners to remove financial and administrative barriers to treatment.
  • Maintain detailed, compliant documentation of all case activities, payer interactions, and authorization statuses within the HUB CRM system to ensure transparency, reporting accuracy, and audit readiness.
  • Evaluate authorization outcomes to determine next steps, including appeals, bridge program eligibility, or alternative access solutions in alignment with manufacturer program.
  • Monitor therapy status and coordinate prior authorization renewals or reauthorizations to support continuity of care and prevent treatment interruptions.
  • Ensure adherence to all regulatory and privacy requirements, including the Health Insurance Portability and Accountability Act (HIPAA), as well as manufacturer program policies and standard operating procedures.
  • Deliver a high-touch customer experience by maintaining professional, empathetic communication with patients and healthcare providers throughout the access
  • Support onboarding and ongoing training of team members; contribute to knowledge sharing and best practices within the HUB environment.
  • Demonstrate strong knowledge of payer landscapes, specialty pharmacy workflows, and manufacturer HUB services, ensuring alignment with program-specific requirements.
  • Perform additional duties as needed to support patient access objectives and overall HUB program success.


QUALIFICATIONS AND REQUIREMENTS
Previous Experience:

  • Previous experience in managing prior authorizations or working knowledge of the prior authorization process is highly preferred.
  • Strong understanding of medical terminology, insurance plans and authorization.
  • Bilingual English/Spanish is a plus.
  • Minimum 3 years of pharmacy or healthcare experience.
  • Ability to manage cases from multiple clientele programs and follow program business.
  • Proficiency with data entry functions, Microsoft applications, and hands-on computer skill.
  • Ability to work independently and on a team.
  • Excellent communication, problem solving and customer service.
  • Strong organizational /interpersonal skills; attention to detail and the ability to multitask.
  • Ability to use multiple PC monitors and navigate through several software systems effectively.

Education:

  • High School Graduate required, College degree preferred.
  • State Pharmacy Technician registration or PTCB National Certification preferred.

Physical Demands:

  • Requires sitting, standing, and occasional light lifting.

 This is a full-time position with benefits. Please visit our Contact Us/Opportunities page on our website for more information about our benefits list.

ProMod Rx will never ask for a financial commitment from an applicant, as part of our recruitment process.  All interviews are conducted in-person OR through video conference invitations from official company emails.  For inquiries, please contact our official recruitment team at HumanResources@procarerx.com.

ProMod Rx is an Equal Opportunity Employer.