ZipRecruiter

Log In

1

Prior Authorization Jobs (NOW HIRING)

Neuroscience Group

Prior Authorization Specialist

Appleton, WI · On-site

$17.25 - $22.75/hr

Prior Authorization Specialist Neuroscience Group is growing! We are adding to our Prior Authorization team. Neuroscience Group has an immediate opening for a full time Prior Authorization Specialist.

Curant Health

Prior Authorization Specialist

Smyrna, GA

$18 - $24/hr

The Prior Authorization specialist responsibilities includes: taking in-bound calls from providers, PBM, etc. providing phone assistance to all callers through the prior authorization process.

Neuroscience Group

Prior Authorization Specialist

Appleton, WI · On-site

$17.25 - $23/hr

We are adding to our Prior Authorization team. Neuroscience Group has an immediate opening for a full time Prior Authorization Specialist. This position will work Monday - Friday 8 hours per day. As ...

MC-Rx

Prior Authorization Coordinator

Miramar, FL · On-site

$21 - $23/hr

Manage the full lifecycle of prior authorization (PA) requests in support of manufacturer-sponsored patient support programs, utilizing payer portals, electronic submission platforms, fax, and ...

next page

Showing results 1-20

People also search for

All JobsPrior Authorization Jobs

Prior Authorization information

See salary details

$13

$20

$32

How much do prior authorization jobs pay per hour?

As of Jun 6, 2026, the average hourly pay for prior authorization in the United States is $20.89, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $23.08 per hour, depending on experience, location, and employer.

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.
More about Prior Authorization jobs
What cities are hiring for Prior Authorization jobs? Cities with the most Prior Authorization job openings:
What are the most commonly searched types of Prior Authorization jobs? The most popular types of Prior Authorization jobs are:
What states have the most Prior Authorization jobs? States with the most job openings for Prior Authorization jobs include:
What job categories do people searching Prior Authorization jobs look for? The top searched job categories for Prior Authorization jobs are:
Prior Authorization jobs near you
Prior Authorization Representative

Prior Authorization Representative

Vitreoretinal Surgery PLLC

Minneapolis, MN • Hybrid

Full-time

Medical, Dental, Vision, Life, PTO

Posted 19 days ago

Job description

Apply Here: https://secure.onehcm.com/ta/VRSPLLC.jobs?ShowJob=620913089&TrackId=ZipRecruiter

We are seeking a detail oriented and patient focused individual to work as a Prior Authorization Specialist at our Edina, MN business office (3 days in office / 2 days work from home).

If you have a passion for providing exceptional patient care, are highly personable, team-oriented, attuned to accuracy and fine detail, and would like to advance your career in the medical field, we would like to talk to you!

Responsibilities for a Prior Authorization Specialist include:

  • Coordinate prior authorization requests with insurance companies.
  • Use internal technology, reports and spreadsheets to determine if prior authorizations are necessary.
  • Request prior authorizations by website and phone.
  • Follow up on prior authorization requests.
  • Review approved prior authorizations and enters information into patient’s chart and account.
  • Review denied prior authorizations and appeals when appropriate.
  • Coordinate with clinic staff, physicians and co-workers to accomplish prior authorization process.

Required Skills, Abilities and Attributes for a Prior Authorization Specialist include:

  • Medical insurance experience
  • Empathy for patients
  • Solid understanding of medical terminology
  • High attention to detail
  • Strong computer experience (multi screens, heavy website navigation, speed and accuracy in moving from window to window, etc.)
  • 10 key by touch
  • 50 wpm typing
  • Experience with AllScripts software
  • Problem solving skills
  • Love to research and solve puzzles
  • Previous prior authorization experience
  • Willingness to have tough conversations with insurance companies
  • Strong organizational skills
  • One year experience with appeal submissions and/or medical billing and coding certificate strongly preferred
  • Ability to read and interpret EOBs
  • An overall understanding of appeals processes through completion
  • Efficient and highly accurate user of applicable information technology and health care management systems
  • Meticulous attention to detail and ability to complete the job with minimal errors
  • Ability to prioritize and manage time effectively
  • Knowledge of HIPAA guidelines
  • Excellent oral and written communication skills
  • Be an excellent team player who works cooperatively and respectfully with all doctors, supervisors, and co-workers.

We offer excellent compensation and benefits, to include:

  • Paid Holidays - 7 days per year
  • Personal Time Off (PTO) - 16 days per year
  • Health Insurance
  • Health Savings Account
  • Dental Insurance (100% company paid single coverage)
  • Flexible Spending Accounts
  • Basic and Supplemental Term Life Insurance (100% company paid single coverage)
  • Long Term Disability (free single coverage)
  • Long Term Care (100% company paid single coverage)
  • Short-Term Disability
  • Vision Insurance
  • Pet Insurance
  • Annual $250 uniform (scrubs and shoes) reimbursement

About Retina Consultants of Minnesota (RCM):

RCM has 9 Minnesota locations - St, Louis Park, Edina, Edina Specialty, Woodbury, Blaine, Duluth, Maplewood, Anoka, and Mankato.

Everything we do…. every decision we make…takes our Guiding Principles into consideration. Our guiding principles are:

  • We exist to serve our patients. We will provide the best available medical skills, technology, and service. We will be their advocates. We will care for our patients as if they were members of our family. We will treat our patients with respect, dignity, and kindness.
  • We are proud of our dedicated staff. We will strive to provide a rewarding career with opportunity for personal and professional growth. We will promote teamwork. We will provide a respectful and safe working environment.
  • We are humbled that other doctors entrust their patients to our care. We will be available when we are needed. We will promptly communicate the results of patient evaluation and treatment. We will respect the referring doctors’ relationships with their patients.
  • We recognize that we have a responsibility to our community. We will strive to be desire to perpetually “Learn and Grow”
  • Efficient and highly accurate user of applicable information technology and health care management systems
  • A good corporate citizen. We will function ethically. We will be prudent in our stewardship of healthcare resources.
  • Medical advances are critical to our patients. We will remain at the forefront in the search for new knowledge and treatments of retinal disease. We will participate in clinical research. We will share our knowledge with our patients and referring doctors, and with our retinal colleagues around the world.