Medicaid specialist vs authorization specialist

The differences between medicaid specialists and authorization specialists can be seen in a few details. Each job has different responsibilities and duties. While it typically takes 1-2 years to become a medicaid specialist, becoming an authorization specialist takes usually requires 2-4 years. Additionally, a medicaid specialist has an average salary of $44,308, which is higher than the $36,518 average annual salary of an authorization specialist.

The top three skills for a medicaid specialist include patients, home health and medicaid eligibility. The most important skills for an authorization specialist are patients, customer service, and insurance verification.

Medicaid specialist vs authorization specialist overview

	Medicaid Specialist	Authorization Specialist
Yearly salary	$44,308	$36,518
Hourly rate	$21.30	$17.56
Growth rate	-	-4%
Number of jobs	73,368	71,831
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 53%	Bachelor's Degree, 33%
Average age	46	40
Years of experience	2	4

What does a medicaid specialist do?

A Medicaid Specialist is a social service worker who focuses on assisting individuals when it comes to Medicaid programs. They are responsible for helping individuals understand the health care system procedures and requirements, answering inquiries, or referring them to other services. There are also Medicaid specialists who mostly perform clerical support tasks such as gathering and verifying documents, conducting research and analyses, handling calls and correspondence, reaching out to medical facilities and insurance companies, and maintaining records.

What does an authorization specialist do?

An authorization specialist is responsible for reviewing insurance claims and determining the necessary settlement for the clients and involved parties. Authorization specialists file documents and gather the required information for further investigation and analysis. They coordinate with the insurance agency and the medical institution and ensure that the correct communications are being sent out for reference. An authorization specialist must have excellent communication and organizational skills, especially in writing authorization requests and resolve claims timely and efficiently.

Medicaid specialist vs authorization specialist salary

Medicaid specialists and authorization specialists have different pay scales, as shown below.

	Medicaid Specialist	Authorization Specialist
Average salary	$44,308	$36,518
Salary range	Between $29,000 And $67,000	Between $28,000 And $47,000
Highest paying City	-	Milford, MA
Highest paying state	-	Massachusetts
Best paying company	-	Guidehouse
Best paying industry	-	Health Care

Differences between medicaid specialist and authorization specialist education

There are a few differences between a medicaid specialist and an authorization specialist in terms of educational background:

	Medicaid Specialist	Authorization Specialist
Most common degree	Bachelor's Degree, 53%	Bachelor's Degree, 33%
Most common major	Business	Business
Most common college	University of Michigan - Ann Arbor	University of Pennsylvania

Medicaid specialist vs authorization specialist demographics

Here are the differences between medicaid specialists' and authorization specialists' demographics:

	Medicaid Specialist	Authorization Specialist
Average age	46	40
Gender ratio	Male, 16.7% Female, 83.3%	Male, 15.4% Female, 84.6%
Race ratio	Black or African American, 21.6% Unknown, 4.2% Hispanic or Latino, 14.7% Asian, 7.8% White, 50.5% American Indian and Alaska Native, 1.2%	Black or African American, 10.8% Unknown, 5.5% Hispanic or Latino, 22.6% Asian, 6.9% White, 53.6% American Indian and Alaska Native, 0.8%
LGBT Percentage	7%	7%

Differences between medicaid specialist and authorization specialist duties and responsibilities

Medicaid specialist example responsibilities.

Generate reports for managing compliance with Medicaid documentation in support of electronic billing to MCO
Acquire valuable expertise of HIPAA, Medicaid and patient confidentiality.
Provide excellent compassionate customer service to all patients, honoring patient privacy according to HIPAA regulations.
Review referrals and screen all uninsure patients seen at contract HCA hospitals for potential Medicaid and/or disability eligibility.
Adhere to all HIPPA laws.
Ensure ICD-9-CM, CPT, and HCPCS codes are correct for billing.

Authorization specialist example responsibilities.

Demonstrate knowledge of HIPAA by appropriately managing patient confidentiality.
Utilize CMS and InterQual criteria to establish authorizations for members requiring medical services for a Medicare advantage insurance company.
Build authorization, match ICD-10 codes with there procedure codes
Provide patients with patient registration forms in order to follow up on patient check-in and check-out utilizing a proprietary management system.
Obtain verification of insurance coverage and authorizations for clinical visits and surgical procedures for patients.
Perform all components of the office registration including arrival, check-in and future appointments.

Medicaid specialist vs authorization specialist skills

Common medicaid specialist skills

Patients, 23%
Home Health, 13%
Medicaid Eligibility, 13%
Rehabilitation, 9%
Social Work, 5%
Term Care, 4%

Common authorization specialist skills

Patients, 20%
Customer Service, 10%
Insurance Verification, 6%
Medical Terminology, 6%
Insurance Eligibility, 4%
Veterans, 4%

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Medicaid Specialist
Medicaid Specialist vs Authorization Specialist

Updated January 8, 2025

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