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How much do prior authorizations specialist jobs pay per hour?

As of Sep 8, 2026, the average hourly pay for prior authorizations specialist 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 a prior authorizations specialist?

A Prior Authorizations Specialist is a healthcare administrative professional responsible for obtaining approval from insurance companies before certain medical procedures, medications, or services are provided to patients. They review clinical documentation, communicate with healthcare providers and insurers, and ensure all necessary paperwork is completed to secure coverage. Their work helps prevent delays in patient care and reduces the risk of denied insurance claims.

What are the key skills and qualifications needed to thrive as a prior authorizations specialist?

To thrive as a Prior Authorizations Specialist, you need a solid understanding of medical terminology, insurance policies, and healthcare procedures, often supported by experience in medical billing or coding. Familiarity with electronic medical record (EMR) systems, payer portals, and prior authorization software is typically required. Outstanding attention to detail, problem-solving abilities, and strong communication skills help manage complex authorization processes and coordinate with providers and insurers. These skills ensure accurate, timely processing of authorizations, minimizing delays in patient care and supporting healthcare revenue cycles.

What are some common challenges faced by prior authorizations specialists, and how can they be addressed?

Prior Authorizations Specialists often face challenges such as navigating complex insurance requirements, managing high volumes of requests, and ensuring timely approvals to prevent delays in patient care. Staying organized and up-to-date with changing payer guidelines is crucial. Effective communication with providers, patients, and insurance representatives is also key to resolving issues quickly. Leveraging technology, such as electronic health record (EHR) systems and payer portals, can streamline workflows and reduce errors.

What is the difference between Prior Authorizations Specialist vs Insurance Claims Processor?

AspectPrior Authorizations SpecialistInsurance Claims Processor
CredentialsTypically requires knowledge of insurance policies, healthcare regulations, and sometimes certifications like CPC or CPC-HOften requires familiarity with claims processing systems and basic insurance knowledge, with certifications like CPC helpful but not mandatory
Work EnvironmentHealthcare offices, hospitals, or insurance companiesInsurance companies, healthcare providers, or third-party claims processing centers
Employer & Industry UsageUsed in healthcare and insurance sectors to manage prior authorization requestsUsed across insurance companies and healthcare providers to process claims and reimbursements

While both roles involve insurance and healthcare, the Prior Authorizations Specialist focuses on obtaining approvals before treatment, whereas the Insurance Claims Processor handles post-treatment claims for reimbursement. Understanding these differences helps job seekers target the right roles in the healthcare insurance industry.

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Prior Authorizations Specialist jobs near you
Infographic showing various Prior Authorizations Specialist job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 77% Full Time, 19% Part Time, 1% Temporary, and 2% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $43,459 per year, or $20.9 per hour.

Prior Authorizations Specialist - Bariatrics

Hartford HealthCare at Home

Glastonbury, CT • On-site

$18 - $24/hr

Full-time

Re-posted 16 days ago

Job description

Work where every moment matters.
Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network.
Hartford HealthCare Medical Group is one of the largest medical practices in New England with multiple locations throughout Connecticut and Rhode Island. We consist of a team of professionals ranging from Medical Assistants to Physician Assistants and everything in between. Our physician led medical group enjoys an excellent reputation with patients and the medical community, offering primary care, urgent care and more than 30 different specialties.
Job Description
Under the direction of the Manager, a Prior Authorization Specialist performs all clerical duties required to obtain insurance prior authorizations for all in office procedures, medications, and any surgical services in a timely manner. Responsible for creating, maintaining and managing resources, including insurance portal access. Must have consistent documentation in EPIC to support the obtained insurance authorization. Will communicates changes in payer and or federal regulatory guidelines to their manager, providers and other clinical departments, as applicable.
• Monitors and reviews the prior authorization work queue daily to verify accuracy of patient's insurance information and to interpret insurance pre-authorization requirements for scheduled procedure, surgery and or medication.
• Contacts insurance companies to obtain prior authorization via telephone and/or portals and provides necessary clinical documentation to ensure authorization is obtained prior to the scheduled date of procedure.
• Documents in EPIC prior authorization information obtained such as number of treatments authorized, length of time treatment is authorized, authorization numbers, and insurance company contact or call reference number.
• Immediately communicates to provider when a procedure, medication or surgery is denied by the insurance company. Assists in setting up peer to peer reviews
• Collaborates and communicates with pharmacy regarding preferred drugs on the particular insurance plan and notifies providers of alternatives
• Maintains log of missed prior authorizations and assists manager with timely retro authorizations or appeals to recoup revenue.
• Collaborates with various hospital departments around billing, information management, policies, procedures and general operations related to prior authorizations.
• When time allows can help out in the office with managing incoming phone calls, baskets and other front desk coverage, answering phones and transcribing orders and referrals.
• Monitoring referral work queue, registering arriving patients, answering incoming calls as well as other assigned duties as needed.
Qualifications:
• High School Graduate/Diploma preferred
• At least one year experience working with insurances and prior authorizations, preferred
• Experience and knowledge of insurances and prior authorizations
• Ability to effectively and professionally communicate with physicians, clinical and administrative staff, managers, patients and insurance companies
• Must be self-motivated and have the ability to work independently and within a team
• Demonstrates excellent telephone, computer, organization and customer service skills
We take great care of careers.
With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge - helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.
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About Hartford HealthCare at Home

Sourced by ZipRecruiter

Hartford HealthCare at Home, based in Wethersfield, Connecticut, US, is a premier provider in the healthcare industry, specifically in home-based care services. Their official website can be accessed at hartfordhealthcareathome.org. They offer a wide range of services including nursing, physical therapy, occupational therapy, speech therapy, social work, and home health aid. The company was established with the mission to enhance the capability of people to achieve optimal health and wellbeing through its home care services. They maintain a patient-centric approach and belief in making a real difference in people's lives. As an integral part of Hartford HealthCare, they share the vision to be “most trusted for personalized coordinated care”.

Industry

Health care and social assistance

Company size

201 - 500 Employees

Headquarters location

Wethersfield, CT, US

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