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Prior Authorization Jobs in Decatur, GA (NOW HIRING)

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 ...

First Lithonia Medical Center

Be Seen First

Medical Assistant (WILLING TO TRAIN)

Austell, GA · On-site

$18 - $19/hr

Submit prior authorization requests * Vaccine management with inventory of 200 + vaccines * Assist providers with 5+ procedures a day * Administer vaccines and therapeutic injections * Assisting ...

First Lithonia Medical Center

Be Seen First

Medical Assistant (WILLING TO TRAIN)

Austell, GA · On-site

$18 - $19/hr

Submit prior authorization requests * Vaccine management with inventory of 200 + vaccines * Assist providers with 5+ procedures a day * Administer vaccines and therapeutic injections * Assisting ...

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All JobsPrior Authorization JobsPrior Authorization Jobs in Decatur, GA

Prior Authorization information

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$13

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$31

How much do prior authorization jobs pay per hour?

As of Jul 21, 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.

How to become a prior authorization specialist?

To become a prior authorization specialist, candidates typically need a high school diploma or equivalent, along with 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 Professional Coder (CPC) can enhance job prospects.

What jobs pay $4000 a week without a degree?

Jobs that can pay $4,000 a week without a degree include certain sales roles, real estate agents, commercial pilots, and skilled trades such as electricians or plumbers with experience. These positions often require specialized skills, certifications, or licensing but do not necessarily require a college degree. High earnings typically depend on experience, performance, and the industry environment.

How much do precertification specialists make?

Precertification specialists typically earn between $35,000 and $55,000 annually, depending on experience, location, and employer. They often require knowledge of insurance policies and medical billing systems, and some roles may offer additional benefits or bonuses.

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 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.

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 career paths follow prior authorization?

Careers following prior authorization typically 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 working in insurance companies, healthcare providers, or pharmacy benefit management companies.
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 July 2026, with employment types broken down into 1% As Needed, 85% Full Time, 11% Part Time, and 3% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $42,431 per year, or $20.4 per hour.
Senior Insurance Verifier

Senior Insurance Verifier

Children's Healthcare of Atlanta

Atlanta, GA • On-site

Full-time

Re-posted 18 days ago

Children's Healthcare Of Atlanta rating

7.5

Company rating: 7.5 out of 10

Based on 127 frontline employees who took The Breakroom Quiz

231st of 886 rated healthcare providers

Job description

Note: If you are CURRENTLY employed at Children's and/or have an active badge or network access, STOP here. Submit your application via Workday using the Career App (Find Jobs).
Work Shift
Day
Work Day(s)
Friday, Monday, Thursday, Tuesday, Wednesday
Shift Start Time
8:00 AM
Shift End Time
4:30 PM
Worker Sub-Type
Regular
Children's is one of the nation's leading children's hospitals. No matter the role, every member of our team is an essential part of our mission to make kids better today and healthier tomorrow. We're committed to putting you first, and that commitment is at the heart of our company culture: People first. Children always. Find your next career opportunity and make a difference doing what you love at Children's.
Job Description
Serves as expert/senior team member while participating in authorization and pre-certification of healthcare services to prevent claims denial and/or appointment cancellation/rescheduling due to authorization issues (e.g., ensuring referring physician obtains prior authorization from insurance company for all scheduled healthcare procedures within assigned department/area). Provides ongoing communication and training to physician offices, patients/families, and others to resolve authorization- related departmental issues. Coordinates changes in process and provides learning materials and resources. Proactively identifies and communicates financial resources available if health plan does not include coverage for services. Coordinates counseling services with Financial Counseling. Collaborates with Patient Financial Services (PFS) department regarding denied claims. Initiates and performs revenue cycle activities required for insurance verification, authorization, and pre-registration. Works collaboratively with team members to provide quality service. Supports the leadership team as needed.
Experience
  • 3 years of healthcare insurance verification experience, including authorizations
  • Epic experience

Preferred Qualifications
  • Bachelor's degree
  • Experience in a pediatric hospital
  • Epic SuperUser

Education
  • High school diploma or equivalent

Certification Summary
  • Certified Healthcare Access Associate Certification (CHAA) within six (6) months of employment as Senior Insurance Verifier

Knowledge, Skills, and Abilities
  • Working knowledge of medical terminology
  • Demonstrated ability to multitask and problem-solve
  • Ability to work independently in a changing environment and handle stressful situations.
  • Ability to read, analyze and interpret medical and supply publications, technical procedures and/or training tools
  • When applicable, specialized focus on assignment or location, must be able to analyze in depth account review including but not limited to, denial management, clinical follow up, and act as a liaison between clinical stakeholders and payor representation
  • Excellent verbal and written communication skills
  • May require travel within Metro Atlanta as needed
  • Must be able to speak and write in a clear and concise manner to convey messages
  • Proficient in Microsoft Word/Excel/Outlook
  • Knowledge of Availity, MMIS and insurance payer websites

Job Responsibilities
  • Assists Management Team with quality assurance, productivity monitoring and monthly reporting.
  • Performs daily quality audits to ensure all healthcare services are authorized and documented accurately and timely.
  • Conducts in depth account review including but not limited to, denial management, clinical follow up, and acts as a liaison between clinical stakeholders and payor representation.
  • Interviews patients and/or family members to secure insurance coverage, eligibility, and qualification for various financial programs.
  • Coordinates and performs verification of insurance benefits by contacting insurance provider and determining eligibility of coverage and communicates status of verification/authorization process with appropriate team members in a timely and efficient manner.
  • Provides clinical information as needed, emphasizing medical justification for procedure/service to insurance companies for completion of pre-certification process.
  • Confirms referring physician and/or servicing physician has obtained notification/confirmation of prior authorization as needed from insurance company for all scheduled healthcare procedures within assigned department/area.
  • Contacts referring physicians and or/patients to discuss rescheduling of procedures due to incomplete/partial authorizations.
  • Acts as liaison between clinical staff, patients, referring physician's office, and insurance by informing patients and families of any possible changes, updates, responses or follow up. Discussion points may include the following: authorization delays, authorization denials, pending status, answering questions regarding status changes, offering assistance, providing follow up steps for financial support and relaying/documenting messages pertaining to authorization of procedure/service.
  • Monitors patients on schedule, ensuring that eligibility and authorization information has been entered into data entry systems.
  • Depending on payer, pre-screens new patient doctor's orders (scripts) to ensure completeness/appropriateness of scheduled appointment.
  • Collaborates with Patient Financial Services (PFS) department to provide all related information regarding denied claims.
  • Monitors insurance authorization issues to identify trends and participates in process improvement initiatives.
  • Responds to all inquiries within the system and outside related to authorization/pre-certification issues.
  • Develops and maintains knowledge in medical terminology, billing and insurance guidelines to ensure Children's remains compliant with all regulatory expectations.
  • Will assist with training, shadowing, and quality assurance for new employees.

Children's Healthcare of Atlanta is an equal opportunity employer committed to providing equal employment opportunities to all qualified applicants and employees without regard to race, color, sex, religion, national origin, citizenship, age, veteran status, disability or any other characteristic covered by applicable law.
Primary Location Address
1575 Northeast Expy NE
Job Family
Patient Access

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