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Prior Authorization Jobs in Lexington, SC (NOW HIRING)

Capitol Urology

Medical Assistant

Columbia, SC · On-site

$18 - $20/hr

Manage referrals and prior authorizations * Answer phones and respond to emails professionally and promptly * Prepare, clean, and stock exam rooms * Manage medical supply inventory and place orders ...

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All JobsPrior Authorization JobsPrior Authorization Jobs in Lexington, SC

Prior Authorization information

See Lexington, SC salary details

$11

$17

$27

How much do prior authorization jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for prior authorization in Lexington, SC is $17.88, according to ZipRecruiter salary data. Most workers in this role earn between $14.81 and $19.76 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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Prior Authorization jobs near you
Infographic showing various Prior Authorization job openings in Lexington, SC as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 19% Part Time, 1% Temporary, and 3% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $37,199 per year, or $17.9 per hour.

Neuroscience Therapeutic Sales Specialist (Greenville, SC)

COMPASS Pathways

Columbia, SC • On-site

Full-time

Posted 25 days ago

Job description

Company introduction:

Compass Pathways plc (Nasdaq: CMPS) is a biotechnology company dedicated to unlocking urgently needed new treatment options in mental health care. 

The Company is headquartered in London, UK, with a U.S. office in New Jersey. We believe mental health patients deserve the possibility of a better future. Our initial focus is developing COMP360 psilocybin, a proprietary, investigational, synthetic psilocybin treatment under evaluation for treatment-resistant depression (TRD) and post-traumatic stress disorder (PTSD). COMP360 is a potentially first-in-class treatment and has Breakthrough Therapy designation from the U.S. Food and Drug Administration (FDA), as well as Innovative Licensing and Access Pathway (ILAP) designation in the UK for TRD. 

We are leading the world's largest classic psychedelic clinical program in TRD, and building upon that robust foundation, we are executing a late-stage trial evaluating COMP360 for PTSD, another condition with high unmet need. Our goal is to advance treatments that move the field of psychiatry towards treatment options that offer rapid onset and sustained durability with infrequent dosing. - Compass Pathways

Job overview:  

The Therapeutic Sales Specialist (TSS) is a field-based, individual contributor role responsible for driving adoption and appropriate use of an innovative mental health therapy at certified treatment centers within a defined territory. This role will execute against the regional commercial strategy by developing strong partnerships with psychiatrists, healthcare providers, and integrated care systems, while ensuring alignment with regulatory, safety, and patient access frameworks.

The TSS will play a critical role in the launch of a novel therapeutic modality, engaging providers through a highly consultative, clinically driven approach. This individual will operate at the intersection of clinical education, account management, and patient access, helping to shape a new treatment ecosystem in mental health.

Location: Field based in Greenville, SC -  Columbia, SC- Charleston, SC and able to travel up to 70%, dependent upon geography. 

Reports to: Regional Sales Director.

Roles and responsibilities 
(Include but are not limited to): 

  • Execute territory-level commercial strategy to support successful launch and uptake of the company's innovative mental health therapy
  • Develop and maintain strategic relationships with psychiatrists, treatment centers, behavioral health systems, and other key stakeholders
  • Deliver scientifically accurate, compliant, and compelling product and disease-state education to healthcare providers
  • Identify appropriate patients and support healthcare providers in understanding patient selection and referral pathways
  • Collaborate with certified treatment sites to support onboarding, readiness, and optimization of treatment delivery workflows
  • Navigate site-of-care dynamics, including scheduling, patient flow, and operational considerations unique to the treatment model
  • Partner cross-functionally with Medical Affairs, Market Access, Patient Support, and Commercial Operations to ensure coordinated execution
  • Support patient access by understanding reimbursement pathways, assisting providers with access-related challenges, and connecting to relevant resources
  • Gather and communicate actionable field insights to inform brand strategy, patient journey optimization, and launch execution
  • Manage territory business planning, including account prioritization, call planning, and performance tracking
  • Demonstrate highly ethical, compliant, and patient-centric behaviors in all engagements
  • Contribute to a culture of collaboration, accountability, and continuous learning within the broader sales organization

Candidate Profile:

  • Bachelor's degree required (advanced degree preferred)
  • 5–8+ years of pharmaceutical or biotech sales experience, preferably in specialty or complex therapeutic areas
  • Experience in the below is preferred:
    • Psychiatry, CNS, or behavioral health markets
    • Medical and pharmacy benefit reimbursement
    • Buy-and-bill and site-of-care dynamics
    • Prior authorization and payer processes
  • Demonstrated success in launching novel therapies or operating in pre-launch environments
  • Experience working with specialty treatment centers, IDNs, academic medical centers, or complex site-of-care models preferred
  • Strong clinical acumen and ability to communicate complex scientific concepts in a clear and compelling way
  • Proven track record of building trust-based relationships with healthcare providers
  • Experience supporting therapies requiring site certification, specialized administration, or coordinated care delivery models is highly desirable
  • Highly collaborative, with the ability to work effectively across cross-functional teams
  • Strong business acumen, territory management, and organizational skills

Compensation Description (annually):

Our compensation package for permanent hires includes base salary, discretionary bonus, and equity, alongside our comprehensive benefits offering.

Please note that the base salary range is a guideline, and individual total compensation will vary based on factors such as qualifications, skill level, competencies, and work location.

【Base salary per annum】:
$165,000—$195,000 USD
Benefits:

For an overview of our benefits package and compensation information, please visit  "Joins us - Our Benefits".

These include flexibility & generous time off, parental & reproductive support, health & medical, mental health & wellbeing and Financial health.

Equal opportunities: 

Reasonable accommodation
We are committed to building a workplace where everyone's wellbeing matters. If you need reasonable accommodation during the interview process to be at your best, please let our recruiting team know. 

UK applicants

We are proud of our commitment to diversity and equality (pursuant to the Equality Act 2010). We do not discriminate based upon race, religion or belief, colour, nationality, ethnic or national origin, gender, pregnancy or maternity, marital or civil partner status, sexual orientation, gender reassignment, age or disability.

US applicants

Compass Pathways is proud to be an equal opportunity employer. All employment decisions are based on business needs, job requirements, and individual qualifications, without regard to race, religion, color, national origin, sex (including pregnancy, childbirth, and related medical conditions), ethnicity, age, disability, sexual orientation, gender identity, gender expression, military service, genetic information, familial or marital status, or any other status, category, or characteristic protected by applicable law.

Sponsorship:

Unfortunately, we cannot sponsor employment visas and can only accept applications if you have employment rights in the country to which you are applying.

Data Privacy:

All data is confidential and protected by all legal and data privacy requirements, please see our recruitment Privacy Notice to learn more about how we process personal data.