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Prior Authorization Jobs in Springfield, OR (NOW HIRING)

The US Oncology Network

Insurance Reviewer

Eugene, OR · On-site

$22 - $32/hr

Minimum three (3) years of prior authorization experience required. Revenue cycle experience preferred. PHYSICAL DEMANDS: The physical demands described here are representative of those that must be ...

The US Oncology Network

Insurance Reviewer

Eugene, OR · On-site

$22 - $32/hr

Minimum three (3) years of prior authorization experience required. Revenue cycle experience preferred. PHYSICAL DEMANDS: The physical demands described here are representative of those that must be ...

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All JobsPrior Authorization JobsPrior Authorization Jobs in Springfield, OR

Prior Authorization information

See Springfield, OR salary details

$14

$21

$33

How much do prior authorization jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for prior authorization in Springfield, OR is $21.63, according to ZipRecruiter salary data. Most workers in this role earn between $17.93 and $23.89 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, OR?

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

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

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

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

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

Prior Authorization jobs near you
Infographic showing various Prior Authorization job openings in Springfield, OR as of August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 22% Part Time, 1% Temporary, and 2% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $44,982 per year, or $21.6 per hour.

RCM Prior Authorization Specialist - Remote

Slocumcenter

Eugene, OR • On-site

$50 - $70/hr

Other

Posted 2 days ago

New

Job description

  • Submits, tracks, and manages prior authorization requests for medical and ancillary procedures, within strict timeframes.
  • Researches and resolves authorization and referral claim denials, while coordinating with physicians, providers, and insurance payers to file appeals or facilitate a P2P.
  • Reviews patient medical records and clinical documentation to ensure they meet payer coverage criteria.
  • Collaborate with the RCM Prior Authorization Supervisor and Team Lead to develop and update authorization policies and procedures.
  • Maintain knowledge of payer guidelines (Medicare, Medicaid, Commercial, etc.) and ensuring regulatory compliance.
  • Partner with the RCM Prior Authorization Supervisor and Team Lead to analyze denied claims resulting from prior authorization and referral errors by identifying the root cause and provide the corrected data to the billing team for the purpose of appealing or resubmitting a corrected claim.
  • Interacts with insurance payers, physicians, providers, and Slocum departments to clarify coverage requirements to expedite approvals.
  • Work in collaboration with the RCM Prior Authorization Supervisor and Team Lead to monitor prior authorization related utilization trends, claim denials, denial rates, and provide performance improvement suggestions to senior leadership.
  • Communicate cross-functionally with providers and other Slocum departments regarding patient questions or referral and authorization concerns.
  • Perform other duties as assigned
  • 2 – 5 years of previous experience as a Prior Authorization Specialist, with expertise in medical billing, healthcare, and the insurance referral process.
  • Strong understanding of medical terminology, ICD-10, CPT, and HCPC coding, and insurance payer policies.
  • Ability to train staff, manage high-volume workflows, and mentor team members.
  • Proficiency in medical billing software / Electronic Health Records (NextGen preferred).
  • Be able to read and understand digital and paper insurance Explanation of Benefits.
  • Strong attention to detail (Accuracy in code selection is critical for compliance and reimbursement.
  • Familiarity with CMS and insurance payer guidelines and requirements.
  • Proficient with Microsoft Office Suites (Outlook, Word, and Excel).
  • Possess the ability to prioritize workload daily, weekly and monthly.
  • Strong communication, attention to detail, and problem-solving skills
Summary
  • The RCM Prior Authorization Specialist manages insurance approvals for medical and ancillary services. Monitor the accuracy of prior authorization activity and payer requirements. Act as a liaison between providers, patients, payers. Ability to learn and retain new workflows and changes in insurance payer requirements. Ensure a high level of accuracy in clinical documentation submissions. Handle denials and appeals.
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