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Prior Authorization Jobs in Decatur, GA (NOW HIRING)

We are seeking a Prior Authorization Pharmacy Technician to support members, providers, and pharmacies by processing prior authorization requests for prescription medications. This role is ...

The Prior Authorization Pharmacy Technician is responsible for supporting members, providers, and pharmacies by processing prior authorization requests for prescription medications while ensuring ...

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This includes how staff pull referral details from clinical notes, how prior authorizations get initiated and tracked, and how scheduling gets coordinated with outside specialists. The goal is to ...

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Be Seen First

This includes how staff pull referral details from clinical notes, how prior authorizations get initiated and tracked, and how scheduling gets coordinated with outside specialists. The goal is to ...

New

Be Seen First

This includes how staff pull referral details from clinical notes, how prior authorizations get initiated and tracked, and how scheduling gets coordinated with outside specialists. The goal is to ...

New

The Pharmacist, Prior Authorization (PA) & Appeals, is responsible for reviewing and evaluating prior authorization and appeals requests to determine coverage based on clinical guidelines, pharmacy ...

Pharmacist

Atlanta, GA · Remote

$59/hr

We are seeking licensed Pharmacists to support Prior Authorization and Appeals operations in a fast-paced, high-volume remote environment. This role is responsible for reviewing medication ...

Showing results 21-40

Prior Authorization information

See Decatur, GA salary details

$13

$20

$31

How much do prior authorization jobs pay per hour?

As of Aug 15, 2026, the average hourly pay for prior authorization in Decatur, GA is $20.40, according to ZipRecruiter salary data. Most workers in this role earn between $16.88 and $22.55 per hour, depending on experience, location, and employer.

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 and gain experience in healthcare or insurance billing. Relevant skills include knowledge of medical terminology, insurance policies, and proficiency with electronic health record (EHR) systems; certifications such as Certified Medical Administrative Assistant (CMAA) can also enhance job prospects.

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.

What are the career paths in prior authorization?

Careers in prior authorization typically include roles such as prior authorization specialists, medical reviewers, and healthcare administrators. Advancement can lead to supervisory or managerial positions, and professionals often develop skills in healthcare regulations, insurance policies, and medical coding. Certifications in medical billing and coding can enhance career growth in this field.

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 most commonly searched types of Prior Authorization jobs in Decatur, GA?

The most popular types of Prior Authorization jobs in Decatur, GA are:

What job categories do people searching Prior Authorization jobs in Decatur, GA look for?

The top searched job categories for Prior Authorization jobs in Decatur, GA are:

What cities near Decatur, GA are hiring for Prior Authorization jobs?

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

Infographic showing various Prior Authorization job openings in Decatur, GA as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 20% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $42,431 per year, or $20.4 per hour.

Sr. Account Operations Manager - Prior Authorization Network

McKesson

Alpharetta, GA • Remote

Full-time

Posted 9 days ago


McKesson rating

7.9

Company rating: 7.9 out of 10

Based on 209 frontline employees who took The Breakroom Quiz

47th of 86 rated pharmaceutical


Job description

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care.

What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you.

The Senior Account Operations Manager - PA Network plays a key role in managing complex customer relationships for CoverMyMeds solutions that support pharmacy clients and prior authorization services. This role serves as a primary operational contact for a portfolio of pharmacy customers, including national and regional pharmacy chains and pharmacy management system/software vendor platforms.

In this role, you will help ensure customers receive value from the services they have contracted for, maintain strong day-to-day operational execution, and support healthy program performance. The ideal candidate brings strong client-facing account management experience, sound judgment, data fluency, and the ability to manage escalations and customer conversations with professionalism and confidence.

This position partners closely with cross-functional teams across CoverMyMeds and McKesson to resolve issues, monitor program performance, support contracted deliverables, and advocate for customer needs while balancing operational execution and business objectives.

What You'll Do:

  • Serve as the primary point of contact for day-to-day operational management of a portfolio of complex customer accounts and programs

  • Manage a book of business that may include approximately 15 to 25 customer accounts, balancing urgency, customer needs, program performance, and business impact

  • Partner with pharmacy clients, including retail, national, and regional chains, as well as pharmacy management system or software vendor platforms, in support of prior authorization services

  • Support customers using CoverMyMeds prior authorization solutions and services connected through the Relay Health switch

  • Own execution of contractual deliverables, helping ensure programs are running according to contract terms, billing expectations, timelines, and customer requirements

  • Act as a point of escalation for customer program concerns by investigating issues, coordinating with internal partners, and communicating outcomes clearly and professionally

  • Use data, reports, and program performance insights to identify trends, surface opportunities, and help tell a clear story to customers and internal stakeholders

  • Lead or participate in customer meetings, business reviews, and performance discussions focused on outcomes, program health, and future opportunities

  • Maintain account plans and customer information using Salesforce and other internal tools, ensuring account details, program activity, and follow-up items remain current and organized

  • Collaborate cross-functionally with internal teams such as implementation, client support, sales, product, analytics, technology, and other business partners to resolve issues and improve the customer experience

  • Promote continuous improvement by identifying process enhancements, operational risks, and opportunities to improve service delivery for customer

Basic Requirements:

  • Bachelor's degree in a related field or an equivalent combination of education and relevant experience, and typically requires 4+ years of experience in account operations, account management, customer success, sales, or a closely related client-facing role

  • Experience managing customer relationships in a fast-paced environment where responsiveness, follow-through, prioritization, and sound judgment are critical

  • Ability to communicate effectively with both technical and non-technical audiences, translating program information, data, and operational details into clear business terms

  • Strong organizational skills with the ability to manage multiple accounts, deliverables, escalations, and follow-up items without losing sight of customer commitments

Preferred Skills/Experience:

  • Experience managing complex or high-value customer relationships, strategic accounts, or large books of business

  • Background in healthcare, health technology, pharmacy, pharmacy benefits management, claims adjudication, reimbursement, prior authorization, or related pharmacy market environments

  • Familiarity with pharmacy clients, pharmacy management systems, pharmacy network operations, or services delivered through pharmacy technology platform

  • Knowledge of NCPDP standards is a plus, particularly as they relate to claims adjudication and pharmacy transaction formatting

  • Experience analyzing data, identifying trends, and translating insights into customer-friendly narratives or business recommendations

  • Experience conducting or supporting business reviews, quarterly business reviews, program performance conversations, or executive-level customer discussions

  • Experience using CRM platforms such as Salesforce, as well as reporting or analytics tools such as Tableau, Excel, PowerPoint, or proprietary business applications

  • Ability to influence without authority and partner effectively across product, analytics, technology, sales, implementation, support, and other internal teams

  • Ability to handle escalations, difficult customer conversations, operational issues, and program concerns with composure, professionalism, and a consultative mindset

  • Pharmacy or pharmacy technician experience is a plus, but not required

We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, pleaseclick here.

Our Base Pay Range for this position

$75,800 - $126,300

McKesson has become aware of online recruiting-related scams in which individuals who are not affiliated with or authorized by McKesson are using McKesson's (or affiliated entities, like CoverMyMeds or RxCrossroads) name in fraudulent emails, job postings or social media messages. In light of these scams, please bear the following in mind:
McKesson Talent Advisors will never solicit money or credit card information in connection with a McKesson job application.


McKesson Talent Advisors do not communicate with candidates via online chatrooms or using email accounts such as Gmail or Hotmail. Note that McKesson does rely on a virtual assistant (Gia) for certain recruiting-related communications with candidates.

McKesson job postings are posted on our career site: careers.mckesson.com.

McKesson is an Equal Opportunity Employer

McKesson provides equal employment opportunities to applicants and employees, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, genetic information, or any other legally protected category. For additional information on McKesson's full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page.

McKesson is committed to being an Equal Employment Opportunity Employer and offers opportunities to all job seekers including job seekers with disabilities. If you need a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to (United States) Disability_Accommodation@McKesson.com or (Canada) Accessibility@mckesson.ca. Resumes or CVs submitted to this email box will not be accepted.

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