ZipRecruiter

Log In

1

Prior Authorization Jobs in Springfield, MA (NOW HIRING)

Cigna

Chief Medical Officer, Evernorth

Bloomfield, CT · On-site

This role also provides oversight of key areas of clinical operations, including Pharmacy Prior Authorization (PA) operations. This will include both maintaining the highest level of operations ...

Actalent

Coordination Specialist

Hartford, CT

$22 - $35/hr

Handle prior authorizations for insurances and credentials. * Utilize EMR systems effectively. * Assist in planning and organizing orientation sessions. Essential Skills * Customer service experience

next page

Showing results 1-20

All JobsPrior Authorization JobsPrior Authorization Jobs in Springfield, MA

Prior Authorization information

See Springfield, MA salary details

$13

$20

$31

How much do prior authorization jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for prior authorization in Springfield, MA is $20.34, 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 Springfield, MA?

The most popular types of Prior Authorization jobs in Springfield, MA are:

What are popular job titles related to Prior Authorization jobs in Springfield, MA?

For Prior Authorization jobs in Springfield, MA, the most frequently searched job titles are:

What job categories do people searching Prior Authorization jobs in Springfield, MA look for?

The top searched job categories for Prior Authorization jobs in Springfield, MA are:

What cities near Springfield, MA are hiring for Prior Authorization jobs?

Cities near Springfield, MA with the most Prior Authorization job openings:

Prior Authorization jobs near you
Infographic showing various Prior Authorization job openings in Springfield, MA as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 18% Part Time, 1% Temporary, and 3% Contract. Highlights an 93% Physical, 1% Hybrid, and 6% Remote job distribution, with an average salary of $42,298 per year, or $20.3 per hour.

Pharmacy Prior Authorization Specialist

Onco360

Hartford, CT • On-site, Remote

$23/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 4 days ago

Onco360 rating

7.7

Company rating: 7.7 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

20th of 113 rated pharmacies

Job description

Pharmacy Prior Authorization Specialist – Onco360 Pharmacy
Full-Time | Starting at $23.00/hr and up
Shift times currently available: 9:00am- 5:30pm EST or 9:30 - 6:00 pm EST
Full-Time position working out of the State of Connecticut. This position may work remotely
Sign-On Bonus: $5,000 for employees starting before August 31, 2026!
As our company continues to grow, we strive to hire new team members with a passion for making a difference in our patient's lives.
Why Join Us?
  • A career with purpose: Help patients access life-saving medications.
  • Supportive culture: We value teamwork, respect, integrity, and passion.
  • Growth opportunities: We invest in your professional and personal development.
Company Benefits
  • Medical; Dental; Vision
  • 401k with a match
  • Paid Time Off and Paid Holidays
  • Tuition Reimbursement
  • Quarterly Incentive Bonus
  • Paid Volunteer Day
  • Referral Incentive Program
  • Company Paid Life Insurance; and Short/Long-Term Disability
What You’ll Do
The Pharmacy Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations from insurance carriers by receiving prescriptions, addressing and rectifying rejected claims and conducting necessary third-party authorization requests.
How You’ll Do This
  • Manage prior authorization requests and appeals with insurance carriers.
  • Collaborate with physicians, pharmacists, and other departments.
  • Ensure HIPAA compliance while handling sensitive patient information.
  • Maintain accurate documentation of authorization details.
  • Proactively monitor and renew expiring authorizations.
What You Bring
Required:
  • High School Diploma or GED
  • 1+ years of pharmacy or prior authorization experience
  • Strong communication, organizational, and customer service skills
  • Self-motivated, organized, detail-oriented, and adaptable to changing priorities
  • Knowledge of pharmacy terminology, pharmacy insurance claims, Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, experience with CoverMyMeds
Preferred:
  • Associate degree or Certified Pharmacy Technician (PTCB)
  • 3+ years of experience in pharmacy or prior authorizations
  • Specialty pharmacy experience
Ready to make a meaningful impact? Apply today and help us better the lives of those battling cancer.

What Onco360 employees say

Pay

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply