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Prior Authorization Jobs in Decatur, GA (NOW HIRING)

Elevance Health

Pharmacy Tech II-Bilingual

Atlanta, GA

$16.75 - $20.50/hr

Processes prior authorization requests from physician's offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations. * Provides ...

Healthcare Support Staffing

Pharmacist

Atlanta, GA

$57 - $58/hr

Review specialty medication prior authorization requests (i.e. biopharmaceuticals) according to established treatment protocols, clinical criteria and member benefits. and make coverage ...

Elevance Health

Pharmacy Tech II-Bilingual

Atlanta, GA

$16.75 - $20.50/hr

Processes prior authorization requests from physician's offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations. * Provides ...

AKUDO HEALTHCARE

PHARMACY BILLING SPECIALIST

Austell, GA · Remote

$17 - $20/hr

Initiate and manage prior authorization (PA) requests * Collect required clinical documentation from providers * Maintain detailed records of PA status and outcomes LTC Facility Coordination * Work ...

Walgreens

Specialty Billing Technician

Atlanta, GA · On-site

$20.25 - $26/hr

Processing of prescription exceptions including prior authorizations, triaging of referrals to other Walgreens locations, and proactively identifying copay assistance opportunities. * Responsible for ...

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How much do prior authorization jobs pay per hour?

As of Jun 1, 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 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 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 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.

More about Prior Authorization jobs
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:
Prior Authorization jobs near you
Infographic showing various Prior Authorization job openings in Decatur, GA as of May 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $42,431 per year, or $20.4 per hour.

Infusion Center Intake Coordinator

VIRTIS HEALTH LLC

Atlanta, GA • Remote

$23 - $27/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 3 days ago

Job description

Description

Soleo Health is seeking an Infusion Center Intake Coordinator to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care!


Home infusion experience required, and must be able to work 8:30am-5pm Eastern Time.


Soleo Health Perks:

  • Competitive Wages
  • 401(k) with a Match
  • Referral Bonus
  • Paid Time Off
  • Great Company Culture
  • Annual Merit Based Increases
  • No Weekends or Holidays
  • Paid Parental Leave Options
  • Affordable Medical, Dental, & Vision Insurance Plans
  • Company Paid Disability & Basic Life Insurance
  • HSA & FSA (including dependent care) Options
  • Education Assistance Program


This Position:

The Infusion Center Intake Coordinator is responsible for processing new referrals including but not limited to verifying patient eligibility, test claim adjudication, coordination of benefits, and identifying patient estimated out of pocket costs. They will also be responsible for preparation, submission, and follow up of payer authorization requests. Responsibilities include:

  • Perform benefit verification of all patient insurance plans including documenting coverage of medications, administration supplies, and related infusion services
  • Responsible to document all information related to coinsurance, copay, deductibles, authorization requirements, etc
  • Calculate estimated patient financial responsibility based off benefit verification and payer contracts and/or company self-pay pricing
  • Initiate, follow-up, and secure prior authorization, pre-determination, or medical review including
  • Reviewing and obtaining clinical documents for submission purposes
  • Communicate with patients, referral sources, other departments, and any other external and internal customers regarding status of referral, coverage and/or other updates as needed
  • Refer or assist with enrollment any patients who express financial necessity to manufacturer copay assistance programs and/or foundations
  • Generate new patient start of care paperwork



Schedule:

  • Must be able to work Full time, 40 hours per week, from 8:30am-5pm Eastern Time
  • Must have experience with home Infusion for Prior authorization/Benefits Verification

Requirements

  • High school diploma or equivalent
  • At least 2 years of home infusion specialty pharmacy and/or medical intake/reimbursement experience preferred
  • Working knowledge of Medicare, Medicaid, and managed care reimbursement guidelines including ability to interpret payor contract fee schedules based on NDC and HCPCS units
  • Strong ability to multi-task and support numerous referrals/priorities while ensuring productivity expectations and quality are met
  • Ability to work in a fast-paced environment
  • Knowledge of HIPAA regulations
  • Basic level skill in Microsoft Excel & Word
  • Knowledge of CPR+ preferred


About Us: Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference!



Soleo's Core Values:

  • Improve patients' lives every day
  • Be passionate in everything you do
  • Encourage unlimited ideas and creative thinking
  • Make decisions as if you own the company
  • Do the right thing
  • Have fun!


Soleo Health is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture.


Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor.


Keywords: Prior Auth, Insurance, Referrals, Home Infusion Prior Authorization, Home Infusion Benefits verification, Insurance Verification Specialist, Specialty Infusion Benefits Verification, Now Hiring, Hiring Now, Hiring Immediately, Immediately Hiring

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