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

Molina Healthcare

Care Review Clinician (RN)

Tampa, FL · On-site

$26.41 - $51.49/hr

Required Qualifications • At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant ...

Nira Medical

Medical Assistant

Clearwater, FL · On-site

$16.25 - $21/hr

Obtain prior authorizations for oral and injectable medications using CoverMyMeds and other payer portals. * Coordinate specialty pharmacy medication delivery in advance of scheduled appointments (e ...

Arthritis Associates of Florida

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Medical Accounts Receivable (A/R) Specialist

Palm Harbor, FL · On-site

$20 - $23/hr

Verify coverage, prior authorization requirements, deductibles, coinsurance, and patient financial responsibility. * Follow up on high-dollar infusion claims and specialty drug reimbursement issues.

Arthritis Associates of Florida

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Medical Accounts Receivable (A/R) Specialist

Palm Harbor, FL · On-site

$20 - $23/hr

Verify coverage, prior authorization requirements, deductibles, coinsurance, and patient financial responsibility. * Follow up on high-dollar infusion claims and specialty drug reimbursement issues.

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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.

Patient Access Specialist

Premier Community Healthcare Grp.

Spring Hill, FL • On-site

$14.75 - $19.75/hr

Full-time

Posted 3 days ago

New

Job description

Patient Access Specialist

1 Position New Port Richey,FL & 1 Position Spring Hill, FL

General Description

The Patient Access Specialist serves as the primary connection between patients, healthcare providers, and Premier Community HealthCare's in-house pharmacy. This position is responsible for ensuring eligible patients have seamless access to prescribed medications by coordinating services from prescription initiation through medication pickup or delivery.

The Patient Access Specialist helps remove barriers to care by assisting patients with medication affordability, insurance navigation, prior authorizations, and patient assistance programs. Working collaboratively with providers and pharmacy staff, this role supports medication adherence, enhances the patient experience, and promotes utilization of Premier's pharmacy services while advancing the organization's mission to improve the health of the communities it serves.

Essential Duties & Responsibilities

  • Serve as the primary liaison between providers and the in-house pharmacy to ensure timely communication, prescription coordination, and continuity of patient care.
  • Identify, enroll, and retain eligible patients in Premier's in-house pharmacy services to improve medication access and continuity of care.
  • Guide patients throughout the medication process, from prescription referral through pickup or delivery, ensuring no patient is lost to follow-up.
  • Assess patient needs and recommend the most appropriate pharmacy and financial assistance solutions to improve medication affordability.
  • Assist patients with prior authorizations, insurance formulary requirements, manufacturer assistance programs, copay assistance, and medication access resources.
  • Promote Premier's in-house pharmacy services to patients and providers while supporting patient acquisition and pharmacy growth initiatives.
  • Maintain a working knowledge of pharmacy operations, including prescription intake, processing, fulfillment, and medication distribution.
  • Utilize Epic and pharmacy management systems to accurately document referrals, monitor prescription status, and coordinate patient care.
  • Assist with prescription processing and pharmacy technician responsibilities when needed to support patient care and pharmacy operations.
  • Maintain strict HIPAA compliance and protect patient confidentiality at all times.
  • Communicate issues affecting prescription turnaround times, medication access, or patient care to pharmacy leadership and providers.
  • Participate in Quality Improvement (QI) and Quality Assurance (QA) initiatives to improve operational efficiency and patient outcomes.
  • Support Premier's mission through community outreach and patient education initiatives.
  • Perform other duties as assigned.

Knowledge, Skills & Abilities

  • Strong understanding of pharmacy operations, prescription workflow, and medication fulfillment processes.
  • Working knowledge of medication assistance programs, manufacturer free-drug programs, prior authorization processes, insurance benefits, and formulary requirements.
  • Proficiency using Epic Electronic Medical Records (EMR) and pharmacy management software.
  • Ability to assess patient needs and identify solutions that improve medication access and affordability.
  • Strong relationship-building and consultative skills to effectively collaborate with patients, providers, pharmacists, and healthcare teams.
  • Excellent organizational skills with the ability to manage multiple referrals while maintaining exceptional attention to detail.
  • Ability to safely handle medications while adhering to pharmacy regulations, privacy standards, and chain-of-custody procedures.
  • Demonstrated professionalism, integrity, and commitment to confidentiality.
  • Exceptional customer service skills with empathy and compassion for diverse patient populations.
  • Strong verbal and written communication skills with the ability to interact effectively across all levels of the organization.
  • Excellent grammar, interpersonal, and problem-solving skills.
  • Commitment to Premier Community HealthCare's mission, vision, and core values.

Qualifications

  • High School Diploma or GED required.
  • Associate's degree or completion of an accredited Pharmacy Technician training program preferred.
  • Current Florida Registered Pharmacy Technician license required.
  • Pharmacy Technician Certification (PTCB – CPhT) required.
  • Minimum one (1) to two (2) years of experience in a pharmacy, patient access, medication access, or healthcare customer service environment.
  • Working knowledge of prior authorization processes and medication/patient assistance programs.
  • Bilingual (English/Spanish) preferred.
  • Ability to obtain and maintain Epic certification and complete annual compliance requirements.

Working Conditions & Physical Requirements

  • Ability to lift 20 lbs. regularly and 30–50 lbs. occasionally.
  • Ability to sit for extended periods.
  • Direct exposure to computer screens.
  • Possible exposure to contagious or infectious diseases.
  • Ability to stand at the pharmacy counter and move throughout the pharmacy and clinic to support patient care and prescription fulfillment.
  • Ability to travel between Premier Community HealthCare locations as needed for coverage, meetings, or operational support.