ZipRecruiter

Log In

1

Prior Authorization Jobs in Raleigh, NC (NOW HIRING)

BCforward

Prior Authorization

Raleigh, NC

$17.50 - $23.25/hr

Company Description About BCforward BCforward began as an IT business solutions and staffing firm. Founded in 1998, BCforward has grown with our customers' needs into a full service personnel ...

Actalent

Pharmacy Technician-PBR

Cary, NC

$22 - $24/hr

Communicate the need for medication prior authorization to providers and serve as a knowledgeable resource throughout the prior authorization process. * Manage inbound calls from patients, clients ...

Actalent

Pharmacy Technician

Cary, NC

$22 - $24/hr

Communicate the need for medication prior authorization to providers and serve as a knowledgeable resource throughout the prior authorization process. * Manage inbound calls from patients, clients ...

McKesson

Patient Access Specialist

Cary, NC

$16 - $21.25/hr

Communicate the need for medication prior authorization (PA) to providers and serve as a resource to the provider during the PA process. * Manage inbound calls from patients, clients, physicians ...

McKesson Corporation

Patient Access Specialist

Cary, NC · On-site

$16 - $21.25/hr

Communicate the need for medication prior authorization (PA) to providers and serve as a resource to the provider during the PA process. * Manage inbound calls from patients, clients, physicians ...

McKesson

Patient Access Specialist

Cary, NC

$16 - $21.25/hr

Communicate the need for medication prior authorization (PA) to providers and serve as a resource to the provider during the PA process. * Manage inbound calls from patients, clients, physicians ...

A-Line Staffing Solutions

Clinical Pharmacist

Cary, NC · On-site

$60/hr

Pharmacist license in state of residence, active and in good standing Prior authorization experience in PBM or managed care environment Experience in PBM, Managed Care, or VA Veterans Hospital

next page

Showing results 1-20

All JobsPrior Authorization JobsPrior Authorization Jobs in Raleigh, NC

Prior Authorization information

See Raleigh, NC salary details

$13

$20

$31

How much do prior authorization jobs pay per hour?

As of Jun 29, 2026, the average hourly pay for prior authorization in Raleigh, NC is $20.31, according to ZipRecruiter salary data. Most workers in this role earn between $16.83 and $22.45 per hour, depending on experience, location, and employer.

How much do precertification specialists make?

Precertification specialists typically earn a median annual salary between $40,000 and $55,000, depending on experience, location, and employer. They often require knowledge of insurance policies and medical billing software, with some roles offering additional certifications to increase earning potential.

What Is Prior Authorization?

Prior authorization is a check done by insurance companies and other third-party payers to determine whether or not they should pay for a medical procedure or specific medication. Factors that can trigger prior authorization requests include things like age, the availability of alternative medicines, or the need to check for drug interactions. If they reject the prior authorization, payers often require doctors to attempt the insurance company's preferred procedure and verify unsuccessful results before accepting an alternative treatment plan. Pre-authorization requests can take up to 30 days, though insurance companies and healthcare providers are continuing to work on ways to cut this time down.

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.

What does a prior authorization job do?

A prior authorization specialist reviews and processes requests for approval of medical procedures, medications, or treatments from insurance companies. They verify patient information, ensure documentation is complete, and communicate with healthcare providers and insurers to obtain necessary approvals, often using electronic health record systems. This role helps ensure that necessary care is authorized while complying with insurance policies.

What job makes $10,000 a month without a degree?

High-paying jobs that can reach $10,000 a month without a degree include roles like sales managers, real estate brokers, or certain skilled trades such as electricians or plumbers, especially with experience and certifications. These positions often require strong skills, industry knowledge, and sometimes licensing, but not necessarily a college degree.

What is prior authorization in healthcare?

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 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 working in insurance companies, healthcare providers, or pharmacy benefit management companies.
More about Prior Authorization jobs
What are the most commonly searched types of Prior Authorization jobs in Raleigh, NC? The most popular types of Prior Authorization jobs in Raleigh, NC are:
What are popular job titles related to Prior Authorization jobs in Raleigh, NC? For Prior Authorization jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Prior Authorization jobs in Raleigh, NC look for? The top searched job categories for Prior Authorization jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Prior Authorization jobs? Cities near Raleigh, NC with the most Prior Authorization job openings:
Prior Authorization jobs near you
Infographic showing various Prior Authorization job openings in Raleigh, NC as of June 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $42,244 per year, or $20.3 per hour.
Prior Authorization

Prior Authorization

BCforward

Raleigh, NC

$17.50 - $23.25/hr

Other

Posted 3 days ago

Job description

Company Description

About BCforward BCforward began as an IT business solutions and staffing firm. Founded in 1998, BCforward has grown with our customers' needs into a full service personnel solutions organization. BCforward's headquarters are in Indianapolis, Indiana and also operates delivery centers in 17 locations in North America as well as Hyderabad, India and Puerto Rico. We are currently the largest consulting firm and largest MBE certified firm headquartered in Indiana. With 14+ years of uninterrupted growth, the addition of two brands (Stafforward and PMforward) and a team of more than 1400 resources our teams deliver services for multiple industries from both public and private sectors. BCforward's team of dedicated staffing professionals has placed thousands of talented people over the past decade, with retention rates that are consistently higher than the industry average.

Job Description

Provide functional and/or technical expertise to plan, analyze, define and support the delivery of future functional and technical capabilities for an application or group of applications. Assist in facilitating impact assessment efforts and in producing and reviewing estimates for client work requests. 

Hours: 8:00am to 5:00pm

Additional Information

Must be able to pass a background and drug screen

BCforward logo

About BCforward

Sourced by ZipRecruiter

BCforward began as an IT business solutions and staffing firm. Founded in 1998, BCforward has grown with our customers' needs into a full service personnel solutions organization. Headquartered in Indianapolis, Indiana, BCforward also operates numerous delivery centers across North America and India. We are currently the largest consulting firm and largest MBE certified firm in Indiana. Our uninterrupted growth has allowed BCforward to deliver uniquely configured IT staffing and project solutions for over years of catering to our customers' specific needs. BCforward currently maintains a team of over 5000 global resources. With our additional brand, Stafforward, together we have the capabilities to deliver services for a variety of industries in both public and private sectors which allows us to address your most challenging needs.

Industry

It services

Company size

5,001 - 10,000 Employees

Headquarters location

Indianapolis, IN, US

Year founded

1998

Social media

FacebookTwitter

View All BCforward Jobs

Apply