ZipRecruiter

Log In

1

Prior Authorization Jobs in Raleigh, NC (NOW HIRING)

McKesson Corporation

Patient Access Specialist

Cary, NC · On-site

$23 - $24/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 · Hybrid

$23 - $24/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

Reimbursement Specialist

Cary, NC · On-site

$21 - $22/hr

Obtains payer specific prior authorization procedures and documentation requirements, if applicable, and facilitates the prior authorization process for patients and healthcare providers. A general ...

McKesson

Reimbursement Specialist

Cary, NC · On-site +1

$21 - $22/hr

Obtains payer specific prior authorization procedures and documentation requirements, if applicable, and facilitates the prior authorization process for patients and healthcare providers. A general ...

McKesson

Reimbursement Specialist

Cary, NC · On-site +1

$21 - $22/hr

Obtains payer specific prior authorization procedures and documentation requirements, if applicable, and facilitates the prior authorization process for patients and healthcare providers. A general ...

NexRep

Healthcare Customer Service Specialists

Apex, NC · 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 ...

Adecco

Pharmacy Technician

Cary, NC · On-site

$22.50/hr

Prior Authorization Specialist ???? Specialty Pharmacy Representative ???? Pharmacy Support Specialist ???? Medical Office Coordinator ???? Healthcare Customer Service Representative ???? Insurance ...

McKesson Corporation

Patient Access Specialist

Cary, NC · On-site

$17.99 - $29.98/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

$15.93 - $26.55/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 ...

previous pagenext page

Showing results 21-40

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 Sep 5, 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.

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 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 August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 18% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $42,244 per year, or $20.3 per hour.

Patient Access Specialist

McKesson Corporation

Cary, NC • On-site

$23 - $24/hr

Full-time

Re-posted 9 days ago

McKesson rating

7.9

Company rating: 7.9 out of 10

Based on 210 frontline employees who took The Breakroom Quiz

46th of 86 rated pharmaceutical

Job description

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care.
What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you.
Mission
At Biologics by McKesson, our mission is to simplify access to medication and deliver personalized care that helps patients achieve the best-possible outcomes - one patient, one partner, one therapy at time.
Purpose
The Patient Access Specialist, Rare/Orphan will be responsible for benefits investigation, prior authorization support, and claims adjudication, as well as refill management and delivery coordination functions in accordance with company policies and procedures.
Compensation: The target rate for this is between $23 and $24 an hour along with a 5% bonus.
Location: This is a hybrid role and will require two days a week in office at our Cary, NC location.
Key Responsibilities
  • Locate and enter accurate prescription insurance information on patient's profile by processing eligibility checks and adjudicating pharmacy claims.
  • Adjudicate claims and troubleshoot rejections so that the correct information is communicated to the patient
  • 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, practitioners and clinics regarding inquiries about order status, services provided, financial support options
  • Serve as a technical resource pertaining to adjudication while identifying areas for improvement.
  • Entering detailed, accurate, and grammatically correct progress notes to ensure proper documentation on patient profiles.
  • Contact patients to schedule medication delivery and payment so that accurate information is included in their profile and distribution can successfully send their package in a timely manner
  • Manage patient refill coordination and follow-up to ensure patients comply with their therapy plan
  • Identify and report adverse events (AEs) and product complaints (PCs) to clinicians to ensure patient's safety
  • Perform other duties as assigned (above tasks may vary slightly depending on the specific team/program requirements.)

Minimum Requirement
Typically requires 1+ years of related experience.
Education & Certification
  • CPhT (Certified Pharmacy Technician) preferred, not required. Must be current, without restrictions, and in good standing
  • High school diploma required

Critical Skills
  • 1+ years prior experience working in a pharmacy or other health care setting required
  • Experience with insurance eligibility and prior authorization processes
  • Competent in basic computer skills and proficiency in Microsoft applications
  • Conscientious, detail oriented with the ability and desire to solve problems to help our patients
  • Flexible, adaptable, and the ability to effectively work in a team setting to accomplish a common goal
  • Highly motivated and committed to excellence with a positive attitude

Additional Skills
  • Strong interpersonal and communication skills; able to engage empathetically with patients and caregivers.
  • Understanding of HIPAA, patient privacy, and compliance regulations.
  • Strong prioritization and time management skills
  • Proficiency in quickly and thoroughly understanding patient and provider needs
  • Demonstrated ability to communicate complex concepts with high efficacy

We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, please click here.
Our Base Pay Range for this position
$15.93 - $26.55
McKesson has become aware of online recruiting-related scams in which individuals who are not affiliated with or authorized by McKesson are using McKesson's (or affiliated entities, like CoverMyMeds or RxCrossroads) name in fraudulent emails, job postings or social media messages. In light of these scams, please bear the following in mind:
McKesson Talent Advisors will never solicit money or credit card information in connection with a McKesson job application.
McKesson Talent Advisors do not communicate with candidates via online chatrooms or using email accounts such as Gmail or Hotmail. Note that McKesson does rely on a virtual assistant (Gia) for certain recruiting-related communications with candidates.
McKesson job postings are posted on our career site: careers.mckesson.com.
McKesson is an Equal Opportunity Employer
McKesson provides equal employment opportunities to applicants and employees, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, genetic information, or any other legally protected category. For additional information on McKesson's full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page.
McKesson is committed to being an Equal Employment Opportunity Employer and offers opportunities to all job seekers including job seekers with disabilities. If you need a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to (United States) Disability_Accommodation@McKesson.com or (Canada) Accessibility@mckesson.ca. Resumes or CVs submitted to this email box will not be accepted.
Join us at McKesson!

What McKesson employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply