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Senior Prior Authorization Analyst Jobs (NOW HIRING)

Equitas Health

Prior Authorization Specialist

Columbus, OH · On-site

$18.13 - $21.78/hr

Provide data on prior authorizations as needed to Senior Leadership. * Other duties as assigned by the Prior Authorization Supervisor, Director of Nursing, and Leadership. * Comply with the Equitas ...

Amerita

Prior Authorization Specialist

Denver, CO · On-site +1

$22/hr

This role requires working knowledge of pharmacy benefits and the prior authorization process ... Basic math and analytical skills * Intermediate typing/keyboard skills About our Line of Business ...

New

BrightSpring

Prior Authorization Specialist

Louisville, KY · On-site

$16.50 - $22/hr

... senior living clients. We offer a non-retail pharmacy environment. Our organization is in high ... The Prior Authorization Coordinator is responsible for striving to complete either approval for ...

BrightSpring

Prior Authorization Specialist

Denver, CO

$30/hr

This role requires working knowledge of pharmacy benefits and the prior authorization process ... Basic math and analytical skills * Intermediate typing/keyboard skills About our Line of Business ...

New

Amerita

Prior Authorization Specialist

Denver, CO · On-site +1

$22 - $30/hr

This role requires working knowledge of pharmacy benefits and the prior authorization process ... Basic math and analytical skills * Intermediate typing/keyboard skills About our Line of ...

New

PharMerica

Prior Authorization Specialist

Louisville, KY · On-site +1

$16.50 - $22/hr

... senior living clients. We offer a non-retail pharmacy environment. Our organization is in high ... The Prior Authorization Coordinator is responsible for striving to complete either approval for ...

PharMerica

Prior Authorization Specialist

Louisville, KY · On-site +1

$16.50 - $22/hr

... senior living clients. We offer a non-retail pharmacy environment. Our organization is in high ... The Prior Authorization Coordinator is responsible for striving to complete either approval for ...

Las Vegas Pain Institute and Medical Center

Be Seen First

Prior Authorization Specialist

Las Vegas, NV · On-site

$16 - $18/hr

Prior Authorization/ B&E A Prior Authorization Specialist: A prior authorization specialist is a ... Analytical Skills: * Detail-Oriented: The ability to review patient files, pull precise clinical ...

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Senior Prior Authorization Analyst information

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$102.5K

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How much do senior prior authorization analyst jobs pay per year?

As of Aug 31, 2026, the average yearly pay for senior prior authorization analyst in the United States is $102,527.00, according to ZipRecruiter salary data. Most workers in this role earn between $88,000.00 and $116,500.00 per year, depending on experience, location, and employer.

What does a senior prior authorization analyst do?

A Senior Prior Authorization Analyst is responsible for reviewing and processing requests for medical procedures, medications, or services to ensure they meet insurance or regulatory requirements before approval. They evaluate clinical documentation, communicate with healthcare providers, and ensure compliance with policies and guidelines. Additionally, they may provide training, resolve complex cases, and help develop procedures to improve efficiency and accuracy in the prior authorization process.

What are the key skills and qualifications needed to thrive as a senior prior authorization analyst, and why are they important?

To thrive as a Senior Prior Authorization Analyst, you need a comprehensive understanding of healthcare policies, insurance guidelines, and medical terminology, typically backed by relevant experience or a degree in healthcare administration or a related field. Familiarity with prior authorization software, claims management systems, and electronic health records (EHRs) is essential, along with certifications such as Certified Professional Coder (CPC) being advantageous. Strong analytical skills, attention to detail, and effective communication are vital soft skills for collaborating with providers and payers. These competencies ensure accurate and efficient authorization processing, reduce claim denials, and support seamless patient care delivery.

What are some common challenges faced by senior prior authorization analysts, and how can they be managed effectively?

Senior Prior Authorization Analysts often encounter challenges such as navigating complex insurance guidelines, managing high volumes of authorization requests, and ensuring timely communication between providers, payers, and patients. Staying organized and up to date with policy changes is essential, as is leveraging workflow tools and collaborating closely with clinical and administrative teams. Proactively addressing issues and maintaining clear documentation can help streamline processes and minimize delays.

What is the difference between Senior Prior Authorization Analyst vs Prior Authorization Coordinator?

AspectSenior Prior Authorization AnalystPrior Authorization Coordinator
CredentialsTypically requires relevant healthcare certifications and experienceOften requires similar certifications but may have less experience requirement
Work EnvironmentPerforms analysis, reviews, and decision-making in healthcare settingsHandles administrative tasks, patient communication, and documentation
Employer & Industry UsageUsed in hospitals, insurance companies, and healthcare providersCommon in clinics, outpatient facilities, and insurance offices

The Senior Prior Authorization Analyst and Prior Authorization Coordinator roles share overlapping credentials and work environments but differ mainly in responsibilities. The analyst focuses on review and decision-making, while the coordinator handles administrative tasks. Both roles are essential in healthcare authorization processes, with the analyst typically requiring more experience and analytical skills.

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Senior Prior Authorization Analyst jobs near you
Infographic showing various Senior Prior Authorization Analyst job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 18% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $102,527 per year, or $49.3 per hour.

Senior Central Prior Authorization Analyst

Adventist Health

Roseville, CA • On-site, Remote

$30.91 - $39.73/hr

Full-time

Re-posted 8 days ago

Adventist Health rating

7.7

Company rating: 7.7 out of 10

Based on 246 frontline employees who took The Breakroom Quiz

165th of 896 rated healthcare providers

Job description


Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect.
Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.
Job Summary:
Serves as a subject matter expert and strategic partner in optimizing infusion site-of-care decisions, pharmacy access, and revenue integrity. This role operates with a high degree of autonomy and is responsible not only for executing complex workflows, but also for leading process improvement initiatives, influencing cross-functional stakeholders, and driving measurable financial and operational outcomes. In coordination with financial clearance, pharmacy, and clinical teams, this role evaluates and determines the most appropriate infusion site of care based on clinical appropriateness, payer policy, and financial impact. The Senior Analyst leverages advanced analytics, deep payer knowledge, and system-wide insights to optimize patient access, minimize denials, and maximize reimbursement across the continuum of care.
Job Requirements:
Education and Work Experience:
  • High School Education/GED or equivalent: Preferred
  • Associate's/Technical Degree or equivalent combination of education/related experience: Preferred
  • Six years' of progressive experience in infusion, specialty pharmacy, revenue cycle, or related healthcare operations: Required
  • Experience in Epic or similar electronic medical records (EMR) platforms: Preferred
  • Knowledge of healthcare insurance, prior authorization and/or coding: Preferred

Licenses/Certifications:
  • State Pharmacy Technician license (CA, OR, &/or HI): Preferred
  • Pharmaceutical Technician Board certification: Preferred
  • Advanced certification (e.g., CHRI, CRCR, or 340B ACE): Preferred
  • Pharmaceutical Technician Board certification: Preferred

Essential Functions:
  • Serves as the lead subject matter expert for infusion site-of-care strategy, payer requirements, and pharmacy benefit optimization. Independently evaluate complex patient cases to determine optimal infusion site of care, balancing clinical appropriateness, payer constraints, and financial impact. Lead coordination with central financial clearance, pharmacy operations, and clinical teams to ensure seamless referral routing across home infusion, ambulatory infusion, and alternate care sites.
  • Oversee and perform advanced benefit investigation, prior authorization strategy, and denials resolution, including escalation of high-risk or high-dollar cases. Identify trends in denials, payer behavior, and workflow inefficiencies; develop and implement data-driven process improvements. Act as a strategic liaison between pharmacy, revenue cycle, and clinical operations to enhance patient access and optimize reimbursement.
  • Provide guidance, training, and mentorship to analysts and technicians; serve as an escalation point for complex issues. Drive standardization of workflows, documentation practices, and referral processes across the health system. Promote and articulate the value of the infusion hub model and site-of-care strategy to internal and external stakeholders. Build and maintain strong relationships with physicians, clinic leadership, pharmacy teams, and payers.
  • Act as a financial advocate for patients, leveraging manufacturer assistance programs, foundations, and alternative funding sources. Participate in or lead cross-functional projects, pilots, and system implementations related to pharmacy services and revenue optimization. Ensure compliance with regulatory requirements (e.g., CMS, payer policies, 340B considerations where applicable).
  • Provide coverage support while maintaining oversight of broader program performance and service delivery. Assesses, develops, and recommends the best method of providing ambulatory infusion pharmacy services to support patients based on health system guidance. Develops and maintains close relationships with clinic staff, physician, pharmacy and other hospital contacts. Independently, and working hand in hand with client authorization resources, facilitates benefits verification and prior authorizations services for infusion site of care patients.
  • Performs other job-related duties as assigned.

Organizational Requirements:
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.
About Us
Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Founded on Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.

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