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Prior Authorization Jobs in Reston, VA (NOW HIRING)

VSI

Insurance Authorization Specialist

Reston, VA · On-site

This role is responsible for obtaining prior authorization for various medical procedures, services, and medications. This is a full-time position working out of our Reston office. The position ...

TEKsystems

Patient Benefit Rep

Silver Spring, MD

$18 - $26/hr

The ideal candidate will have experience with insurance verification, prior authorizations, patient benefits, financial counseling, or patient access functions and be passionate about helping ...

TEKsystems

Patient Benefit Rep

Silver Spring, MD

$18 - $26/hr

The ideal candidate will have experience with insurance verification, prior authorizations, patient benefits, financial counseling, or patient access functions and be passionate about helping ...

American Oncology Network

Financial Counselor

Bethesda, MD · On-site

$20.09 - $33.48/hr

Performs the quality control function for pre-certification and prior authorization. The Financial Counselor ensures the patients' insurance benefits are kept up to date in the electronic medical ...

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All JobsPrior Authorization JobsPrior Authorization Jobs in Reston, VA

Prior Authorization information

See Reston, VA salary details

$14

$21

$33

How much do prior authorization jobs pay per hour?

As of Jul 26, 2026, the average hourly pay for prior authorization in Reston, VA is $21.74, according to ZipRecruiter salary data. Most workers in this role earn between $18.03 and $23.99 per hour, depending on experience, location, and employer.

How to become a prior authorization specialist?

To become a prior authorization specialist, candidates typically need a high school diploma or equivalent, along with 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 Professional Coder (CPC) can enhance job prospects.

What jobs pay $4000 a week without a degree?

Jobs that can pay $4,000 a week without a degree include certain sales roles, real estate agents, commercial pilots, and skilled trades such as electricians or plumbers with experience. These positions often require specialized skills, certifications, or licensing but do not necessarily require a college degree. High earnings typically depend on experience, performance, and the industry environment.

How much do precertification specialists make?

Precertification specialists typically earn between $35,000 and $55,000 annually, depending on experience, location, and employer. They often require knowledge of insurance policies and medical billing systems, and some roles may offer additional benefits or bonuses.

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 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 typically 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 Reston, VA? The most popular types of Prior Authorization jobs in Reston, VA are:
What job categories do people searching Prior Authorization jobs in Reston, VA look for? The top searched job categories for Prior Authorization jobs in Reston, VA are:
What cities near Reston, VA are hiring for Prior Authorization jobs? Cities near Reston, VA with the most Prior Authorization job openings:
Prior Authorization jobs near you
Infographic showing various Prior Authorization job openings in Reston, VA as of July 2026, with employment types broken down into 1% As Needed, 85% Full Time, 11% Part Time, and 3% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $45,213 per year, or $21.7 per hour.

Prior-Authorization Technician- Pharmacy

GW MFA

Arlington, VA

$48K - $63K/yr

Full-time

Posted 5 days ago

Job description

Position Summary

The Prior Authorization Technician will process prior authorizations and locate foundation assistance for GW Medical Faculty Associates providers.

Essential Duties and Responsibilities

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned.

Under the direct supervision of a licensed Pharmacist:

  • Initiate prior authorizations for medications and work with providers on completion
  • Confirm patient demographics are accurate and insurance information is correct
  • Communicate with the clinical team and patients about prior authorization status and provide updates accordingly
  • Identify patient foundation assistance and manufacturer copay assistance programs
  • Follow up with the pharmacy to ensure the medication is in process after approval received
  • Process prior authorization renewals
  • Work with the provider to resolve prior authorization denials, peer-to-peer reviews, and denials
  • At all times, maintain a courteous interaction with patients, visitors, departments, and medical personnel
  • Refer issues that require professional judgment to a pharmacist for follow-up
  • Other duties assigned

Minimum Qualifications

Education

  • High school diploma or an equivalent combination of education, training, and experience

Licenses/Certifications

  •  A valid and active DC, MD, or VA pharmacy license is required.

Experience

  • A minimum of 2 years of Pharmacy Technician experience in retail, specialty, or mail-order pharmacy and a pharmacy license ( Must have  a DC MD or VA active pharmacy license 
    • A minimum of 2 years in an alternative healthcare role (i.e. Certified Nurse Assistant, Medical Assistant, Licensed Practical Nurse) will be considered 

Physical Requirements

  • Stand, walk, bend, twist, and reach for long periods of time in a clinical setting.
  • Must be able to occasionally lift or carry and push or pull up to 100 lbs. as part of the role
  • Regularly exposed to healthcare settings that may require personal protective equipment
  • Requires manual dexterity to operate a computer keyboard, calculator, copier machine, and other equipment.

About GW MFA

MFA physicians provide comprehensive patient care, offering one practice for the whole person with 52 medical and surgical specialties. As members of the GW School of Medicine and Health Sciences faculty, MFA providers are teachers and mentors for medical students, residents, fellows, and researchers preserving the rich tradition of academics, research, and healing. In addition to maintaining a closely integrated alliance with The George Washington University and The George Washington University Hospital (GWUH) which is separately owned and operated by Universal Health Services (UHS), the GW MFA has active referring relationships with 12 area hospitals.

The GW MFA’s leading healthcare presence in the DC metro region is complemented by a network of community-based practices in DC, Maryland, and Virginia. Given its geographic location in central NW Washington, DC, and proximity to more than 175 resident embassies, the MFA continues to evolve its international clinical outreach.

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