Physician specialist vs prior authorization specialist

The differences between physician specialists and prior 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 physician specialist, becoming a prior authorization specialist takes usually requires 2-4 years. Additionally, a physician specialist has an average salary of $210,219, which is higher than the $36,120 average annual salary of a prior authorization specialist.

The top three skills for a physician specialist include patients, patient care and surgery. The most important skills for a prior authorization specialist are patients, customer service, and medical necessity.

Physician specialist vs prior authorization specialist overview

	Physician Specialist	Prior Authorization Specialist
Yearly salary	$210,219	$36,120
Hourly rate	$101.07	$17.37
Growth rate	-8%	-4%
Number of jobs	63,020	69,667
Job satisfaction	-	5
Most common degree	Bachelor's Degree, 42%	Bachelor's Degree, 32%
Average age	49	40
Years of experience	2	4

What does a physician specialist do?

A Physician Specialist is a doctor who specializes in a particular field of medicine, such as pediatrics, urology, psychiatry, and more. Their responsibilities revolve around studying the patients' medical history, conducting assessments and evaluations, developing care and treatment plans, prescribing medication, and helping patients understand their conditions and symptoms. In some cases, a Physician Specialist may recommend patients to undergo surgeries and other procedures. Moreover, aside from treating and diagnosing medical conditions, a Physician Specialist maintains an active communication line with nurses and technicians for a smooth and efficient workflow.

What does a prior authorization specialist do?

Prior Authorization Specialists are individuals responsible for the entire process of prior authorization for a client. They manage communication between stakeholders of clients, healthcare providers, and insurance companies to request for prior authorizations. Their duties include ensuring complete and updated patient and claim documentation, performing daily billings, auditing accounts for accurate submissions claim, and making sure patient treatment reimbursements are processed effectively. Prior Authorization Specialists also review outstanding accounts and handle reimbursement or billing issues to ensure clean billing claims.

Physician specialist vs prior authorization specialist salary

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

	Physician Specialist	Prior Authorization Specialist
Average salary	$210,219	$36,120
Salary range	Between $111,000 And $396,000	Between $27,000 And $46,000
Highest paying City	Bradenton, FL	Framingham, MA
Highest paying state	Delaware	Massachusetts
Best paying company	Saint Luke's Health System	Washington State University
Best paying industry	Health Care	Health Care

Differences between physician specialist and prior authorization specialist education

There are a few differences between a physician specialist and a prior authorization specialist in terms of educational background:

	Physician Specialist	Prior Authorization Specialist
Most common degree	Bachelor's Degree, 42%	Bachelor's Degree, 32%
Most common major	Business	Nursing
Most common college	-	University of Southern California

Physician specialist vs prior authorization specialist demographics

Here are the differences between physician specialists' and prior authorization specialists' demographics:

	Physician Specialist	Prior Authorization Specialist
Average age	49	40
Gender ratio	Male, 25.0% Female, 75.0%	Male, 18.4% Female, 81.6%
Race ratio	Black or African American, 9.6% Unknown, 3.8% Hispanic or Latino, 12.0% Asian, 3.8% White, 70.6% American Indian and Alaska Native, 0.4%	Black or African American, 9.2% Unknown, 5.3% Hispanic or Latino, 23.0% Asian, 6.9% White, 54.9% American Indian and Alaska Native, 0.7%
LGBT Percentage	9%	7%

Differences between physician specialist and prior authorization specialist duties and responsibilities

Physician specialist example responsibilities.

Manage providers' office and call schedules, outlook calendars and assist with surgery scheduling.
Generate referral letters for physicians, manage and sort medical documents within the EHR system, and assist with e-prescribing.
Review complete ultrasound and non-stress testing reports and assign appropriate ICD-10 and CPT codes.
Train in AllScripts EMR system.
Retrieve medical records from EMR and save to flash drive.
File written letters of appeal on claims deny by the Medicaid.

Prior authorization specialist example responsibilities.

Utilize CMS and InterQual criteria to establish authorizations for members requiring medical services for a Medicare advantage insurance company.
Manage quality communication, patient support and service representation with patients and providers to establish equipment/procedures statuses and expedite orders.
Work with staff to ensure proper CPT codes are submit on authorization request.
Demonstrate compassion while obtaining patient demographics and personal health information.
Register patients into the emergency department or outpatients for surgery or procedures.
Register patients' demographics and insurance information; execute daily outpatient and surgery reports.

Physician specialist vs prior authorization specialist skills

Common physician specialist skills

Patients, 39%
Patient Care, 23%
Surgery, 18%
Internal Medicine, 3%
Excellent Interpersonal, 2%
Patient Registration, 2%

Common prior authorization specialist skills

Patients, 18%
Customer Service, 8%
Medical Necessity, 8%
Medical Terminology, 6%
Clinical Resource, 6%
Authorization Process, 4%

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Physician Specialist
Physician Specialist vs Prior Authorization Specialist

Updated January 8, 2025

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