Prior authorization representative vs patient coordinator

The differences between prior authorization representatives and patient coordinators can be seen in a few details. Each job has different responsibilities and duties. It typically takes 2-4 years to become both a prior authorization representative and a patient coordinator. Additionally, a prior authorization representative has an average salary of $38,726, which is higher than the $32,954 average annual salary of a patient coordinator.

The top three skills for a prior authorization representative include patients, customer service and outbound calls. The most important skills for a patient coordinator are patients, customer service, and patient care.

Prior authorization representative vs patient coordinator overview

	Prior Authorization Representative	Patient Coordinator
Yearly salary	$38,726	$32,954
Hourly rate	$18.62	$15.84
Growth rate	-4%	-4%
Number of jobs	55,498	97,878
Job satisfaction	-	-
Most common degree	High School Diploma, 24%	Bachelor's Degree, 40%
Average age	40	40
Years of experience	4	4

Prior authorization representative vs patient coordinator salary

Prior authorization representatives and patient coordinators have different pay scales, as shown below.

	Prior Authorization Representative	Patient Coordinator
Average salary	$38,726	$32,954
Salary range	Between $29,000 And $51,000	Between $25,000 And $41,000
Highest paying City	Attleboro, MA	Brockton, MA
Highest paying state	Massachusetts	Massachusetts
Best paying company	NTT Data International L.L.C.	University of California, Berkeley
Best paying industry	Health Care	Health Care

Differences between prior authorization representative and patient coordinator education

There are a few differences between a prior authorization representative and a patient coordinator in terms of educational background:

	Prior Authorization Representative	Patient Coordinator
Most common degree	High School Diploma, 24%	Bachelor's Degree, 40%
Most common major	Business	Business
Most common college	Howard University	University of Pennsylvania

Prior authorization representative vs patient coordinator demographics

Here are the differences between prior authorization representatives' and patient coordinators' demographics:

	Prior Authorization Representative	Patient Coordinator
Average age	40	40
Gender ratio	Male, 21.1% Female, 78.9%	Male, 11.2% Female, 88.8%
Race ratio	Black or African American, 9.7% Unknown, 5.2% Hispanic or Latino, 18.0% Asian, 5.8% White, 60.6% American Indian and Alaska Native, 0.7%	Black or African American, 11.1% Unknown, 5.3% Hispanic or Latino, 25.4% Asian, 6.2% White, 51.4% American Indian and Alaska Native, 0.7%
LGBT Percentage	7%	7%

Differences between prior authorization representative and patient coordinator duties and responsibilities

Prior authorization representative example 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.

Patient coordinator example responsibilities.

Comply with HIPAA regulations by discreetly and professionally handling all patients private medical information.
Gather personal plus insurance information and perform thorough insurance breakdowns for patients.
Communicate directly with patients to obtain initial patient information and respond to inquiries.
Process and update HIPAA relate paperwork and other require institutional forms as necessary.
Obtain all necessary documentation prior to surgery such as proof of identification, copy of insurance and require insurance referrals.
Respond in writing to all grievances in accordance with CMS and DNV guidelines.

Prior authorization representative vs patient coordinator skills

Common prior authorization representative skills

Patients, 26%
Customer Service, 8%
Outbound Calls, 5%
Medical Terminology, 4%
Data Entry, 4%
Insurance Coverage, 4%

Common patient coordinator skills

Patients, 30%
Customer Service, 11%
Patient Care, 6%
Patient Flow, 5%
Excellent Organizational, 4%
Check-In, 3%

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Office and Administrative Industry
Prior Authorization Representative
Prior Authorization Representative vs Patient Coordinator

Updated January 8, 2025

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