How to hire a prior authorization representative

How to hire a prior authorization representative, step by step

Here's a step-by-step prior authorization representative hiring guide:

• Step 1: Identify your hiring needs
• Step 2: Create an ideal candidate profile
• Step 3: Make a budget
• Step 4: Write a prior authorization representative job description
• Step 5: Post your job
• Step 6: Interview candidates
• Step 7: Send a job offer and onboard your new prior authorization representative
• Step 8: Go through the hiring process checklist

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1. Identify your hiring needs

   First, determine the employments status of the prior authorization representative you need to hire. Certain prior authorization representative roles might require a full-time employee, whereas others can be done by part-time workers or contractors.

   Determine employee vs contractor status

   Is the person you're thinking of hiring a US citizen or green card holder?

   Yes

   No

   You should also consider the ideal background you'd like them a prior authorization representative to have before you start to hire. For example, what industry or field would you like them to have experience in, what level of seniority or education does the job require, and how much it'll cost to hire a prior authorization representative that fits the bill.

   This list shows salaries for various types of prior authorization representatives.

   Type of Prior Authorization Representative	Description	Hourly rate
   Prior Authorization Representative	Customer service representatives interact with customers to handle complaints, process orders, and provide information about an organization’s products and services.	$13-24
   Patient Service Coordinator	Patient services coordinators act as a liaison between a healthcare organization and patients. Their primary job is to provide quality service to patients... Show more	$12-20
   Patient Care Coordinator	A patient care coordinator or care coordinator is a trained health professional who manages patients' health care, such as the elderly or disabled. Patient care coordinators educate patients about their health conditions and develop a plan to address their personal health care needs... Show more	$11-25

   Show more

2. Create an ideal candidate profile

   Common skills:

   • Patients
   • Customer Service
   • Outbound Calls
   • Medical Terminology
   • Data Entry
   • Insurance Coverage
   • Clinical Criteria
   • CPT
   • Inbound Telephone
   • Authorization Request
   • Insurance Verification
   • Insurance Benefits
   • Continuous Improvement
   • Authorization Process

   Check all skills

   Responsibilities:

   • Manage inbound/outbound calls for medical personnel and patients, along with computerize data entry to regulate proper distribution of prescription medication.
   • Utilize knowledge of physician office policies, CPT and ICD-9 coding, procedures, and equipment.
   • Provide compassion without judgment in regards to patient's finances.
   • Determine if CPT and ICD-10 codes are correct and qualify for coverage.
   • Review all daily EDI reports to make sure claims are being accept properly.
   • Perform chart audits via EMR, prepare medical records for subpoenas, general requests.

   More prior authorization representative duties

3. Make a budget

   Including a salary range in your prior authorization representative job description is one of the best ways to attract top talent. A prior authorization representative can vary based on:

   • Location. For example, prior authorization representatives' average salary in arkansas is 48% less than in massachusetts.
   • Seniority. Entry-level prior authorization representatives 43% less than senior-level prior authorization representatives.
   • Certifications. A prior authorization representative with certifications usually earns a higher salary.
   • Company. Working for an established firm or a new start-up company can make a big difference in a prior authorization representative's salary.

   Average prior authorization representative salary

   $38,726yearly

   $18.62 hourly rate

   ---

   Entry-level prior authorization representative salary

   $29,000 yearly salary

   Updated January 20, 2026

   Average prior authorization representative salary by state

   Rank	State	Avg. salary	Hourly rate
   1	Massachusetts	$55,162	$27
   2	New York	$51,997	$25
   3	Maryland	$46,651	$22
   4	West Virginia	$43,485	$21
   5	California	$42,345	$20
   6	Iowa	$41,787	$20
   7	Ohio	$41,600	$20
   8	Nevada	$40,616	$20
   9	Indiana	$40,305	$19
   10	North Carolina	$40,107	$19
   11	Minnesota	$39,313	$19
   12	Illinois	$39,168	$19
   13	Nebraska	$38,733	$19
   14	Oregon	$38,376	$18
   15	New Mexico	$37,607	$18
   16	Utah	$36,608	$18
   17	Georgia	$35,123	$17
   18	Texas	$35,121	$17
   19	Arizona	$34,284	$16
   20	Alabama	$33,363	$16

   Average prior authorization representative salary by company

   Company

   Rank	Company	Average salary	Hourly rate	Job openings
   1	NTT Data International L.L.C.	$68,700	$33.03	4
   2	UMass Memorial Health	$47,766	$22.96	9
   3	Fresenius Medical Care North America Holdings Limited Partnership	$45,399	$21.83	36
   4	University of Rochester	$43,664	$20.99	37
   5	University of Iowa Center for Advancement	$42,152	$20.27	14
   6	Midwest Spine & Brain Institute	$41,477	$19.94
   7	Sturdy Memorial Hospital	$41,463	$19.93	10
   8	Arkansas Children's Hospital	$40,020	$19.24	9
   9	St. Charles Health System	$39,904	$19.18	12
   10	St. Joseph Mantua	$39,847	$19.16
   11	Children's of Alabama	$39,565	$19.02	2
   12	Children's Hospital of Michigan	$38,647	$18.58	1
   13	Sentara Healthcare	$37,961	$18.25	94
   14	Southwest General	$37,645	$18.10	6
   15	CareerBuilder	$37,546	$18.05
   16	CVS Health	$37,346	$17.95	8
   17	Ardent Health Services	$37,291	$17.93	21
   18	Alameda Health Consortium	$37,030	$17.80
   19	Southern Illinois Healthcare	$36,287	$17.45	1
   20	Randstad North America, Inc.	$36,194	$17.40	3

4. Writing a prior authorization representative job description

   A good prior authorization representative job description should include a few things:

   • Summary of the role
   • List of responsibilities
   • Required skills and experience

   Including a salary range and the first name of the hiring manager is also appreciated by candidates. Here's an example of a prior authorization representative job description:

   Prior authorization representative job description example

   NTT DATA Services strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now.
   
   We are currently seeking a Pharmacy Appeals Prior Authorizations Representative to join our team in Lincoln, Rhode Island (US-RI), United States (US).
   
   NTT DATA Services currently seeks a Coordinator - Associate Eligibility Consultant to join our team. If you feel you are qualified by the description below, please apply for a chance to interview and discuss your skills & qualifications.
   Job Description:
   
   The position will work in accordance with the Center for Medicare/Medicaid Services (CMS) guidelines to ensure regulatory compliance takes place. This position requires a strong focus around accurate and timely customer support to ensure member enrollment. Key Responsibilities are as follows:
   
   * Identifying and processing different types of documents and routing them to the correct area for processing.
   * Processing returned mail and updating members addresses
   * Meet monthly established quality and productivity goals on a consistent basis
   * Follow work instructions regarding enrollment tasks
   
   Experience:
   
   * 1 year of overall related experience of Center for Medicare/Medicaid Services (CMS) guidelines for Medicare Part D enrollment processes or previous work experience in regulatory environment
   
   Education:
   
   High School diploma or GED
   
   About NTT DATA Services
   
   NTT DATA Services is a global business and IT services provider specializing in digital, cloud and automation across a comprehensive portfolio of consulting, applications, infrastructure and business process services. We are part of the NTT family of companies, a partner to 85 % of the Fortune 100.
   
   NTT DATA Services is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.

   Copy this example

   

5. Post your job

   There are various strategies that you can use to find the right prior authorization representative for your business:

   • Consider promoting from within or recruiting from your existing workforce.
   • Ask for referrals from friends, family members, and current employees.
   • Attend job fairs at local colleges to find candidates who meet your education requirements.
   • Use social media platforms like LinkedIn, Facebook, and Twitter to reach potential job candidates.

   Post your job online:

   • Post your prior authorization representative job on Zippia to find and recruit prior authorization representative candidates who meet your exact specifications.
   • Use field-specific websites.
   • Post a job on free websites.

6. Interview candidates

   Your first interview with prior authorization representative candidates should focus on their interest in the role and background experience. As the hiring process goes on, you can learn more about how they'd fit into the company culture in later rounds of interviews.

   Remember to include a few questions that allow candidates to expand on their strengths in their own words. Asking about their unique skills might reveal things you'd miss otherwise. At this point, good candidates can move on to the technical interview.

   The right interview questions can help you assess a candidate's hard skills, behavioral intelligence, and soft skills.

7. Send a job offer and onboard your new prior authorization representative

   Once you've selected the best prior authorization representative candidate for the job, it's time to write an offer letter. In addition to salary, this letter should include details about the benefits and perks you offer the candidate. Ensuring that your offer is competitive is essential, as qualified candidates may be considering other job opportunities. The candidate may wish to negotiate the terms of the offer, and you should be open to discussion. After you reach an agreement, the final step is formalizing the agreement with a contract.

   It's equally important to follow up with applicants who don't get the job with an email letting them know that the position has been filled.

   To prepare for the new prior authorization representative first day, you should share an onboarding schedule with them that covers their first period on the job. You should also quickly complete any necessary paperwork, such as employee action forms and onboarding documents like I-9, benefits enrollment, and federal and state tax forms. Finally, Human Resources must ensure a new employee file is created for internal record keeping.

8. Go through the hiring process checklist

   • Determine employee type (full-time, part-time, contractor, etc.)
   • Submit a job requisition form to the HR department
   • Define job responsibilities and requirements
   • Establish budget and timeline
   • Determine hiring decision makers for the role
   • Write job description
   • Post job on job boards, company website, etc.
   • Promote the job internally
   • Process applications through applicant tracking system
   • Review resumes and cover letters
   • Shortlist candidates for screening
   • Hold phone/virtual interview screening with first round of candidates
   • Conduct in-person interviews with top candidates from first round
   • Score candidates based on weighted criteria (e.g., experience, education, background, cultural fit, skill set, etc.)
   • Conduct background checks on top candidates
   • Check references of top candidates
   • Consult with HR and hiring decision makers on job offer specifics
   • Extend offer to top candidate(s)
   • Receive formal job offer acceptance and signed employment contract
   • Inform other candidates that the position has been filled
   • Set and communicate onboarding schedule to new hire(s)
   • Complete new hire paperwork (i9, benefits enrollment, tax forms, etc.)

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