Prior authorization representative vs patient service representative

The differences between prior authorization representatives and patient service representatives 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 service representative. Additionally, a prior authorization representative has an average salary of $38,726, which is higher than the $32,476 average annual salary of a patient service representative.

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

Prior authorization representative vs patient service representative overview

	Prior Authorization Representative	Patient Service Representative
Yearly salary	$38,726	$32,476
Hourly rate	$18.62	$15.61
Growth rate	-4%	-4%
Number of jobs	55,498	165,920
Job satisfaction	-	-
Most common degree	High School Diploma, 24%	Bachelor's Degree, 32%
Average age	40	40
Years of experience	4	4

Prior authorization representative vs patient service representative salary

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

	Prior Authorization Representative	Patient Service Representative
Average salary	$38,726	$32,476
Salary range	Between $29,000 And $51,000	Between $27,000 And $38,000
Highest paying City	Attleboro, MA	Seattle, WA
Highest paying state	Massachusetts	Vermont
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 service representative education

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

	Prior Authorization Representative	Patient Service Representative
Most common degree	High School Diploma, 24%	Bachelor's Degree, 32%
Most common major	Business	Business
Most common college	Howard University	University of Pennsylvania

Prior authorization representative vs patient service representative demographics

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

	Prior Authorization Representative	Patient Service Representative
Average age	40	40
Gender ratio	Male, 21.1% Female, 78.9%	Male, 11.9% Female, 88.1%
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, 10.3% Unknown, 5.3% Hispanic or Latino, 21.5% Asian, 6.3% White, 55.7% American Indian and Alaska Native, 0.7%
LGBT Percentage	7%	7%

Differences between prior authorization representative and patient service representative 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 service representative example responsibilities.

Manage the daily release of charges to A/R.
Adhere with all state and federal regulations such as EMTALA and HIPPA requirements and appropriately collect co-payments and deductibles from patients.
Provide caring and compassion to elderly and developmentally disable patients.
Demonstrate respect, compassion and confidentiality for patients and family members.
Provide professional and accurate service to schedule patient appointments, check-in and verify insurance eligibility.
Provide quality customer service to patients and observe all protocols regarding HIPPA regulations to ensure patient confidentiality.

Prior authorization representative vs patient service representative 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 service representative skills

Patients, 20%
Customer Service, 12%
Excellent Interpersonal, 7%
Check-In, 7%
Patient Service, 6%
Excellent Organizational, 6%

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

Updated January 8, 2025

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