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Prior Authorization Jobs in Decatur, IL (NOW HIRING)

Crossing Healthcare

Care Coordinator

Decatur, IL · On-site

$16.50 - $22/hr

Supervisory Responsibilities: * none Duties/Responsibilities: * process referrals/diagnostics/prior authorizations within outlined workflows * ensure therapeutic relationship with patients to ...

Crossing Healthcare

Care Coordinator

Decatur, IL · On-site

$16.50 - $22/hr

Supervisory Responsibilities: * none Qualifications Duties/Responsibilities: * process referrals/diagnostics/prior authorizations within outlined workflows * ensure therapeutic relationship with ...

Memorial Health

Insurance Pre-Auth Spec I

Lincoln, IL · On-site

$16.50 - $24.82/hr

Overview The Insurance Pre-Authorization Specialist I is responsible for completing prior authorizations, pre-certifications, and notifications for third-party and government payers for pre-scheduled ...

Memorial Health

Insurance Pre-Auth Spec I

Lincoln, IL · On-site

$16.50 - $24.82/hr

Overview The Insurance Pre-Authorization Specialist I is responsible for completing prior authorizations, pre-certifications, and notifications for third-party and government payers for pre-scheduled ...

Memorial Health

Insurance Pre-Auth Spec I

Lincoln, IL · On-site

$16.50 - $24.82/hr

The Insurance Pre-Authorization Specialist I is responsible for completing prior authorizations, pre-certifications, and notifications for third-party and government payers for pre-scheduled elective ...

Memorial Health

Insurance Pre-Auth Spec I

Lincoln, IL · On-site

$16.50 - $24.82/hr

Overview The Insurance Pre-Authorization Specialist I is responsible for completing prior authorizations, pre-certifications, and notifications for third-party and government payers for pre-scheduled ...

Memorial Health

Insurance Pre-Auth Spec I

Lincoln, IL · On-site

$16.50 - $24.82/hr

Overview The Insurance Pre-Authorization Specialist I is responsible for completing prior authorizations, pre-certifications, and notifications for third-party and government payers for pre-scheduled ...

Memorial Health

Insurance Pre-Auth Spec I

Lincoln, IL

$16.50 - $24.82/hr

The Insurance Pre-Authorization Specialist I is responsible for completing prior authorizations, pre-certifications, and notifications for third-party and government payers for pre-scheduled elective ...

Athletico

Front Office Coordinator - Decatur, IL

Decatur, IL · On-site

$16 - $20.75/hr

Strong understanding of insurance verification processes , prior authorization requirements, and financial clearance workflows * Working knowledge of HIPAA compliance and patient privacy standards

AthletiCo

Front Office Coordinator - Decatur, IL

Decatur, IL · On-site

$16 - $20.75/hr

Strong understanding of insurance verification processes, prior authorization requirements, and financial clearance workflows * Working knowledge of HIPAA compliance and patient privacy standards

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All JobsPrior Authorization JobsPrior Authorization Jobs in Decatur, IL

Prior Authorization information

See Decatur, IL salary details

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How much do prior authorization jobs pay per hour?

As of Aug 27, 2026, the average hourly pay for prior authorization in Decatur, IL is $20.27, according to ZipRecruiter salary data. Most workers in this role earn between $16.78 and $22.40 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 top searched job categories for Prior Authorization jobs in Decatur, IL are:

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

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

Prior Authorization jobs near you
Infographic showing various Prior Authorization job openings in Decatur, IL as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 16% Part Time, 1% Temporary, and 2% Contract. Highlights an 93% Physical, 1% Hybrid, and 6% Remote job distribution, with an average salary of $42,154 per year, or $20.3 per hour.

Care Coordinator

Crossing Healthcare

Decatur, IL • On-site

$16.50 - $22/hr

Full-time

Posted 14 days ago

Job description

Job Summary:

The Care Coordinator works along side the RN Care Coordinator to manage transitions of care between facilities, Crossing Healthcare, and other specialists. This team will work closely with the medical records department.

Supervisory Responsibilities:

  • none

Duties/Responsibilities:

  • process referrals/diagnostics/prior authorizations within outlined workflows
  • ensure therapeutic relationship with patients to encourage patient to be active participant in their care
  • ensures referrals/diagnostics are completed, results returned, and follow up care coordinated in a timely manner
  • maintains referral site spreadsheet
  • obtain prior authorizations as needed and access to respective prior authorization portals
  • schedule diagnostics
  • completes ConferMed electronic referrals
  • Process monthly DMH lung screenings
  • Resource for clinical team in regards to referrals, prior authorization and diagnostic processing
  • Act a liaison with local hospitals and maintain relationships with insurance companies and specialist offices
  • Other duties as assigned

Competencies

  • Effective Communicative/Speaking Skills
  • Effective Writing skills
  • Effective logic, reasoning and critical thinking
  • Proficiency in use of telephone, computer and photocopier
  • Strong organizational and interpersonal skills
  • Ability to work independently, exercise creativity, be attentive to detail, and maintain a positive attitude
  • Ability to manage multiple and simultaneous responsibilities
  • Maintain patient confidentiality at all times
  • Comply with all organizational policies and standards regarding ethical business practices
  • Complete annual education requirements
  • Ability to have crucial conversations with staff and peers to ensure team members are held accountable and to ensure clear communication across the organization.

Education and Experience:

  • Certified Medical Assistant
  • Health education experience preferred.
  • Healthcare Office

Physical Requirements:

  • Moderate physical exertion including frequent walking, standing, bending, reaching and carrying moderately heavy loads (up to 25 lbs.
  • Ability to work in conditions that include exposure to blood, bodily fluids and tissues, contagious diseases and/or other potentially hazardous materials

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