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Prior Authorization Jobs in Chicago, IL (NOW HIRING)

ReliaMed

Prior Authorization Specialist

Aurora, IL · On-site

$19.50 - $21.50/hr

Prior Authorization Specialist Since our doors opened in 1989, Reliable Medical has been committed to improving the lives of all who entrust us with their care and those who we entrust to provide it.

Onco360

Pharmacy Prior Authorization Specialist

Woodridge, IL · On-site

$20.25 - $26.25/hr

Pharmacy Prior Authorization Specialist - Onco360 Pharmacy Woodridge, IL | Full-Time | Starting at $23.00/hr and up Sign-On Bonus: $5,000 for employees starting before August 31, 2026! Join a mission ...

Onco360

Pharmacy Prior Authorization Specialist

Woodridge, IL · On-site +1

$20.25 - $26.25/hr

Pharmacy Prior Authorization Specialist - Onco360 Pharmacy Woodridge, IL | Full-Time | Starting at $23.00/hr and up Sign-On Bonus: $5,000 for employees starting before August 31, 2026! Join a mission ...

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All JobsPrior Authorization JobsPrior Authorization Jobs in Chicago, IL

Prior Authorization information

See Chicago, IL salary details

$14

$21

$33

How much do prior authorization jobs pay per hour?

As of Aug 30, 2026, the average hourly pay for prior authorization in Chicago, IL is $21.54, according to ZipRecruiter salary data. Most workers in this role earn between $17.84 and $23.80 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 Chicago, IL?

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For Prior Authorization jobs in Chicago, IL, the most frequently searched job titles are:

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What cities near Chicago, IL are hiring for Prior Authorization jobs?

Cities near Chicago, IL with the most Prior Authorization job openings:

Prior Authorization jobs near you
Infographic showing various Prior Authorization job openings in Chicago, IL as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 19% Part Time, 1% Temporary, 2% Contract, and 1% Nights. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $44,805 per year, or $21.5 per hour.

Prior Authorization Specialist

Keystone Advisors LLC

Matteson, IL • On-site

$17.75 - $23.75/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 18 days ago

Job description

Keystone Advisors is looking for a Prior Authorization Specialist to join our team in Matteson, IL supporting one of our healthcare clients. 
Job Summary

The Prior Authorization Specialist is responsible for obtaining and processing all prior authorization requests, coordinating phone calls, entering and tracking data from insurance providers and health plans regarding authorization, expedited reviews, and appeals. The Prior Authorization Specialist is required to document and track all communication attempts with insurance providers and health plans, follow up on all denials while working to ensure services are validated.  

Typical Duties

  • Reviews accounts, and initiate pre-authorizations, and other requirements related to managed care; route to appropriate departments as needed.
  • Collects demographic, insurance, and clinical information to ensure that all reimbursement requirements are met.
  • Notifies the necessary parties within the required timeframe for routine and urgent requests for services.
  • Assists in monitoring utilization services to assure cost effective use of medical resources through processing prior authorizations.
  • Communicates with patients and/or referring physicians on non-covered benefits or procedure coverage issues.
  • Assists with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed.
  • Provides consistent and comprehensive information (both in writing and verbally) to facilitate approvals.
  • Ensures insurance carrier documentation requirements are met and authorization documentation is entered and recorded in the patient’s records.
  • Appeals pre-authorization denials and/or set-up peer to peer reviews.
  • Maintains an extensive working knowledge and expertise of insurance companies and billing authorization requirements.
  • Identifies and reports undesirable trends and reimbursement modeling errors or underlying causes of incorrect payment; review allowed variances from third party payers.
  • Builds and maintains working relationships with staff, referral sources, insurance companies, and medical providers.

Minimum Qualifications

  • High School diploma or GED equivalent with five (5) years of prior authorization experience OR Bachelor’s degree with two (2) years of prior authorization experience
  • Three (3) years of experience processing insurance requests to obtain prior authorization
  • Experience and familiarity with using insurance portals, i.e., Anthem, Availty, Evicor, Covermymeds, Magellang

Preferred Qualifications

  • Knowledge and experience with payer processes to submit appropriate clinical documentation
  • Experience using Medical Terminology

Knowledge, Skills, Abilities and Other Characteristics

  • Proficiency with Microsoft applications and internet-based programs
  • Strong interpersonal skills with the ability to establish strong working relationships
  • Excellent verbal and written communication skills necessary to communicate with all levels of staff and a patient population composed of diverse cultures and age groups
  • Strong time management skills to prioritize assignments and meet the designated deadline
  • Ability to anticipate, recognize, and meet the needs of the patients and their families
  • Ability to work in a team-based environment to accomplish goals and objectives
  • Ability to demonstrate respect and sensitivity for cultural diversity in client’s work force and patient population
  • Ability to critically think, problem solve and make independent decisions supporting the authorization process, including interactions with payer representatives, physicians, and hospital case managers

Compensation Package:

  • Competitive Salary
  • Paid Time Off
  • Health, Vision & Dental Insurance
  • Health Savings Account (HSA)
  • Flexible Spending Account (FSA)
  • Short & Long Term Disability
  • 401 (K) with company match
  • Life Insurance

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