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Prior Authorization Jobs in Meridian, ID (NOW HIRING)

Albertsons

Specialty Care Coord Tech

Boise, ID

Benefits investigation -- determining coverage, facilitating prior authorization and communicating coverage to the patient. * Care Coordination -- facilitating the buy, bill and administration of SP ...

NexRep

Healthcare Customer Service Specialists

Eagle, ID · On-site

$16/hr

Previous experience with prior authorization, medical coding, or pharmacy benefit structures is helpful. To be a successful Healthcare Customer Service Specialist for this client, it's also essential ...

New

Pharmacy Careers

Formulary Management Pharmacist

Boise, ID · On-site

$55.50 - $66.50/hr

Provide clinical support for utilization management, prior-authorization criteria, and step-therapy guidelines. What You'll Bring * Education: PharmD or Bachelor of Pharmacy. * Licensure: Active U.S ...

Pharmacy Careers

Formulary Management Pharmacist

Meridian, ID · On-site

$56.50 - $67.75/hr

Provide clinical support for utilization management, prior-authorization criteria, and step-therapy guidelines. What You'll Bring * Education: PharmD or Bachelor of Pharmacy. * Licensure: Active U.S ...

Albertsons

Specialty Care Coord Tech

Boise, ID

Experience in acquiring prior authorization from third party payers. * Problem solving abilities and attention to details. * Administration skills, such as planning and organizing, resource ...

Albertsons

Specialty Care Coord Tech

Boise, ID · On-site

Experience in acquiring prior authorization from third party payers. * Problem solving abilities and attention to details. * Administration skills, such as planning and organizing, resource ...

Albertsons

Specialty Care Coord Tech

Boise, ID · On-site

Experience in acquiring prior authorization from third party payers. * Problem solving abilities and attention to details. * Administration skills, such as planning and organizing, resource ...

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All JobsPrior Authorization JobsPrior Authorization Jobs in Meridian, ID

Prior Authorization information

See Meridian, ID salary details

$12

$19

$30

How much do prior authorization jobs pay per hour?

As of Aug 30, 2026, the average hourly pay for prior authorization in Meridian, ID is $19.70, according to ZipRecruiter salary data. Most workers in this role earn between $16.30 and $21.78 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.
More about Prior Authorization jobs

What are the most commonly searched types of Prior Authorization jobs in Meridian, ID?

The most popular types of Prior Authorization jobs in Meridian, ID are:

What are popular job titles related to Prior Authorization jobs in Meridian, ID?

For Prior Authorization jobs in Meridian, ID, the most frequently searched job titles are:

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The top searched job categories for Prior Authorization jobs in Meridian, ID are:

Prior Authorization jobs near you
Infographic showing various Prior Authorization job openings in Meridian, ID 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 $40,981 per year, or $19.7 per hour.

Pharmacy Prior Authorization Technician - MED

LUMA

Boise, ID • On-site

$21/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 4 days ago

Job description

DEDICATED TO STRENGTHENING THE HEALTH, SAFETY, AND INDEPENDENCE OF IDAHOANS
*THIS ANNOUNCEMENT WILL BE OPEN UNTIL FILLED. APPLICANTS ARE ENCOURAGED TO APPLY AS SOON AS POSSIBLE TO BE CONSIDERED.*
The Idaho Department of Health and Welfare's Division of Medicaid is seeking a detail-oriented, customer-focused professional to join our pharmacy team. In this role, you'll support Idahoans by helping ensure they receive safe, timely access to the medications they need. This position offers a dependable Monday thru Friday 8am-5pm schedule.
As a Pharmacy Prior Authorization Technician, you will review pharmacy data, perform accurate data entry, and deliver exceptional customer service as part of the prior authorization process. Your work will directly support pharmacists, providers, and members across the state. This position is located in Boise.
We're looking for someone who brings strong communication skills, thrives in a collaborative environment, and is eligible for registration with the Idaho Board of Pharmacy as a pharmacy technician.
The Idaho Department of Health & Welfare is a drug-free workplace. Any applicant offered employment in this position at the Idaho Department of Health and Welfare will be required to pass a pre-employment drug test.
This position may be eligible for limited telework after successful completion of probation and necessary training. Approval to telecommute is not guaranteed and subject to termination at any time.
BENEFITS:
The State of Idaho offers a robust total compensation and benefits package, including but not limited to:
  • We have one of the Nation's best state retirement systems (PERSI) that offers a lifetime benefit at retirement. 11 paid holidays
  • Paid sick and vacation that begins accruing on your first day of employment; can be used immediately after accruing (no waiting time)
  • Paid parental leave
  • Medical, vision, and dental insurance benefits that become effective first of the month following your hire date. All contributions can be pre-tax (full-time/30+ hours per week)
  • 2 voluntary supplemental retirement plans including both pre-tax and Roth options
  • Deferred compensation plan
  • Life insurance for self, spouse, and children
  • Short and long-term disability insurance
  • Flexible Spending Accounts (FSA)
  • Wide variety of training opportunities
  • Some positions offer flexible hours and/or telecommuting
  • Additional perks and discounts available through medical provider
  • Public Service Loan Forgiveness (PSLF) Eligibility
  • Employee assistance program

Additional information related to benefits and/or State programs can be found here: https://dhr.idaho.gov/StateEmployees/Benefits.html.*
EXAMPLE OF DUTIES:
  • Provides service to callers and technical assistance to participants, doctors, and pharmacies.
  • Conducts initial review, screening, and processing of (prior authorization) pharmacy requests.
  • Prepares informational and related records and reports to ensure accurate data and system compliance with policies and regulations.
  • Explains policies and procedures to providers, clients, and staff.
  • Enters and modifies pharmaceutical data in system and forms.
  • Research drug related information.

MINIMUM QUALIFICATIONS:
You must possess all the minimum qualifications below to pass the exam for this position. Please make sure your resume or work history supports your meeting the minimum qualifications for this position. Failure to do this may disqualify you from being considered for this position. It is highly recommended to attach a one-page cover letter to your application to demonstrate how you meet the requirements below.
  • Good knowledge of medical and pharmaceutical terms and abbreviations. Typically gained by at least one year experience in a pharmaceutical setting as a pharmacy assistant or equivalent OR completion of a formal pharmacy technician school or similar formal training that would have provided this knowledge.
  • Good knowledge of the control and distribution of pharmaceuticals. Typically gained by at least one year experience working with the control and distribution of pharmaceuticals OR completion of pharmacy technician school.
  • Some knowledge of pharmacy inventory control methods and procedures. Typically gained by completion of a pharmacy inventory control course such as in pharmacy technician school OR at least one year experience performing inventory control work in a pharmacy.
  • Some knowledge of the metric system of weights and measures. Typically gained by completing a class in high school or pharmacy education, which provided knowledge to be familiar with system of weights and measures.
  • Experience entering and retrieving data on a computer. Typically gained by at least one year in a work environment.
  • Experience applying and explaining policies. Typically gained by at least one year in a work environment.
  • Experience composing written statements and proofreading correspondence. Typically gained by at least one year in a work environment.
  • Skill in typing/keyboarding at a minimum of 45 words per minute.

Below is preferred experience. It is not required for the position but applicants with this experience may receive consideration over other applicants.
  • Nationally Registered Certified Pharmacy Technician. Typically gained by completion of national exam.
  • Pharmaceutical knowledge. Typically gained by at least one year of relevant experience work in pharmacy.
  • Excellent customer service skills and experience. Typically gained by at least one year of work in a customer service driven capacity.

Learn About a Career with DHW
If relocating to Idaho, the Department of Health & Welfare does not reimburse the cost of relocating and the department does not sponsor anyone with a work visa.
PLEASE NOTE: application assistance is not available after the business hours listed below, on the weekends, or on holidays and you must apply before 11:59 pm on the closing date. When applying, use CHROME as your browser to avoid complications.
If you have questions, please contact us at:
Email is the quickest way to get an answer to your questions.
(answered Monday through Friday during business hours MST)
EMAIL: dhwjobs@dhw.idaho.gov
PHONE:(208) 334-0681
EEO/ADA/Veteran:
The State of Idaho is committed to providing equal employment opportunities and prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on their race, color, religion, political affiliation or belief, sex, national origin, genetics, or any other status protected under applicable federal, state, or local laws.
The State of Idaho is committed to access and reasonable accommodations for individuals with disabilities, auxiliary aids and services are available upon request. If you require an accommodation at any step in our recruitment process, you are encouraged to contact (208) 334-2263 (TTY/TTD: 711), or email ada.coordinator@dhr.idaho.gov.
Preference may be given to veterans who qualify under state and federal laws and regulations.
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About Luma

Sourced by ZipRecruiter

Industry

Arts, entertainment, and recreation

Company size

201 - 500 Employees

Headquarters location

Santa Monica, CA, US

Year founded

2002

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