ZipRecruiter

Log In

1

Prior Authorization Jobs in Port Richey, FL (NOW HIRING)

next page

Showing results 1-20

All JobsPrior Authorization JobsPrior Authorization Jobs in Port Richey, FL

Prior Authorization information

See Port Richey, FL salary details

$12

$18

$28

How much do prior authorization jobs pay per hour?

As of Aug 9, 2026, the average hourly pay for prior authorization in Port Richey, FL is $18.52, according to ZipRecruiter salary data. Most workers in this role earn between $15.34 and $20.48 per hour, depending on experience, location, and employer.

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 and gain 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 Medical Administrative Assistant (CMAA) can also enhance job prospects.

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.

What are the career paths in prior authorization?

Careers in prior authorization typically include roles such as prior authorization specialists, medical reviewers, and healthcare administrators. Advancement can lead to supervisory or managerial positions, and professionals often develop skills in healthcare regulations, insurance policies, and medical coding. Certifications in medical billing and coding can enhance career growth in this field.

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.
More about Prior Authorization jobs
What are the most commonly searched types of Prior Authorization jobs in Port Richey, FL? The most popular types of Prior Authorization jobs in Port Richey, FL are:
What job categories do people searching Prior Authorization jobs in Port Richey, FL look for? The top searched job categories for Prior Authorization jobs in Port Richey, FL are:
What cities near Port Richey, FL are hiring for Prior Authorization jobs? Cities near Port Richey, FL with the most Prior Authorization job openings:
Prior Authorization jobs near you
Infographic showing various Prior Authorization job openings in Port Richey, FL as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $38,529 per year, or $18.5 per hour.

Prior Authorization Technician - Pharmacy Technician Florida License required

Shields Health Solutions

Tampa, FL

$16.50 - $20/hr

Full-time

Posted 2 days ago

New

Shields Health Solutions rating

8.3

Company rating: 8.3 out of 10

Based on 39 frontline employees who took The Breakroom Quiz

12th of 112 rated pharmacies

Job description

Job Purpose:

In this role, the individual will support patient care by removing barriers to medication access. This includes working with insurance companies and clinician offices to facilitate medication approvals through prior authorizations, as well as collaborating with patients and various funding sources, such as foundations or pharmaceutical manufacturers, to obtain financial assistance for high-cost copays. The role also involves providing phone support to patients, navigating pharmacy dispensing systems to adjudicate claims, process refills, and promoting medication adherence.

Job Duties:

  • Communicate directly with insurance companies to facilitate medication approvals.
  • Navigate pharmacy operating systems to input data, adjudicate test claims, and develop action plans for follow-up.
  • Communicate effectively across databases, electronic medical records, and email systems to document patient concerns, prior authorization status, and financial assistance needs.
  • Review prescriptions with physicians' offices to ensure optimal patient care.
  • Maintain complete and accurate records of patient communications.
  • Assist patients with managing their pharmacy insurance claims.
  • Collaborate closely with pharmacists and pharmacy liaisons to deliver a coordinated, high-quality patient care experience.
  • Communicate directly with patients via phone to support medication adherence and compliance.
  • Research and analyze information to support strategic decision-making.
  • Manage, organize, and update relevant data within database systems.
  • Apply observations and recommendations to improve operations, productivity, quality, and customer service standards.
  • Identify trends, resolve issues, recommend improvements, and implement changes.
  • Participate actively in process improvement initiatives.
  • Act as a value-added business partner to stakeholders across the organization.
  • Protect organizational value by maintaining confidentiality of information.
  • Maintain professional knowledge by participating in educational opportunities, reading professional publications, and engaging in professional networks and organizations.
  • Minimal in-state or out-of-state travel may be required.
  • Perform other duties as assigned.

Experience/ Education:

Required Licensure/Certification: We are seeking experienced, state registered pharmacy technicians. If the candidate lives in a state that does not require registration (i.e. Delaware, Hawaii, New York), candidate agrees to obtain a state license withing 6 months of employment and must be nationally certified (PTCB or NHA) at time of hire. In all other cases, PTCB or NHA is highly preferred but not required (must be obtained within 9 months of employment). Should additional licensure need to be obtained, the applicant will commit to obtaining the required licensure within a mutually agreed upon timeframe. Continued employment is contingent upon meeting these requirements.

Years of Experience: Required 1+ years as a Pharmacy Technician

Education: High school diploma or GED required

California residents employed by or applying for work at Shields have certain privacy rights. Please review our: California Workforce Privacy Notice and Privacy Policy.

By providing your mobile number, you agree to receive text messages from Shields Health Solutions related to job opportunities, interview scheduling, and recruiting updates. Message and data rates may apply. You may opt out at any time by replying 'STOP.' Consent is not a condition of employment.

Solid computer skills are required, including proficiency in Microsoft Office tools (Outlook, Teams, Word, Excel, and PowerPoint) for communication, documentation, and data management, as well as, navigating the internet and web-based platforms. Data entry and computer skills will be evaluated through an assessment as part of the pre-employment process.

Shields Health Solutions provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Shields Health Solutions is committed to providing an inclusive hiring experience; if you need assistance or accommodation during the application or interview process, please email talentacquisition@shieldsrx.com.

What Shields Health Solutions employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom