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Prior Authorization Jobs (NOW HIRING)

Lumera Healthcare

Prior Authorization Associate

Paducah, KY · On-site

$18.25 - $22.50/hr

Submit complete, timely, and accurate prior authorization requests to insurance companies and health plans. Follow-up Management: Track the status of authorization requests, including appeals for ...

MC-Rx

Prior Authorization Coordinator

Miramar, FL

$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 ...

MC-Rx

Prior Authorization Coordinator

Gainesville, GA

$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 ...

Anchor Health CT

Prior Authorization Specialist

Hamden, CT · On-site

$48K - $62K/yr

The Role This role is responsible for prior authorization workflows, patient-specific electronic fax management, and clinical support within the EPIC EMR, ensuring timely, accurate coordination ...

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How much do prior authorization jobs pay per hour?

As of Jun 28, 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.

How much do precertification specialists make?

Precertification specialists typically earn a median annual salary between $40,000 and $55,000, depending on experience, location, and employer. They often require knowledge of insurance policies and medical billing software, with some roles offering additional certifications to increase earning potential.

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 does a prior authorization job do?

A prior authorization specialist reviews and processes requests for approval of medical procedures, medications, or treatments from insurance companies. They verify patient information, ensure documentation is complete, and communicate with healthcare providers and insurers to obtain necessary approvals, often using electronic health record systems. This role helps ensure that necessary care is authorized while complying with insurance policies.

What job makes $10,000 a month without a degree?

High-paying jobs that can reach $10,000 a month without a degree include roles like sales managers, real estate brokers, or certain skilled trades such as electricians or plumbers, especially with experience and certifications. These positions often require strong skills, industry knowledge, and sometimes licensing, but not necessarily a college degree.

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 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 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:
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Prior Authorization jobs near you
Infographic showing various Prior Authorization job openings in the United States as of June 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $43,459 per year, or $20.9 per hour.

Prior Authorization Associate

Lumera Healthcare

Paducah, KY • On-site

$18.25 - $22.50/hr

Other

Posted 22 days ago

Job description

Insurance Authorization Coordinator

Ensures that necessary approvals are obtained from insurance companies for Targeted Case Management and IOP programs by liaising with qualified providers, staff and payers. Tracking the authorization process daily.

Key responsibilities include submitting requests to insurers, monitoring for approvals or denials, updating patient records, and communicating with all TCM/IOP staff to facilitate timely care and revenue cycle efficiency.

Information Gathering: Collect and compile necessary clinical information from patients' charts to support the authorization request.

Communication with Payers: Submit complete, timely, and accurate prior authorization requests to insurance companies and health plans.

Follow-up Management: Track the status of authorization requests, including appeals for denied requests, to ensure services are approved.

Liaise with Program coordinators: Act as a point of contact between referring providers and insurance companies, providing updates and resolving issues.

Data Entry and Documentation: Accurately enter and update patient and claim information in relevant locations

Issue Identification: Identify trends or issues in prior authorization that lead to delays in claim processing or patient care.

Required Skills and Qualifications:

Communication: Strong verbal and written communication skills to interact with patients, providers, and insurance companies.

Attention to Detail: Meticulous attention to detail for accurately collecting and entering sensitive information.

Organizational Skills: Ability to multitask and manage a high volume of requests and documentation.

Computer Proficiency: Familiarity with healthcare billing systems, electronic health records (EHR), and general computer skills.

Insurance Knowledge: Understanding of Kentucky State insurance guidelines, managed care protocols, and prior authorization processes.

Experience: Previous experience in Behavioral Health medical billing /coding, or referral coordination preferred.

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