Prior authorization representative vs representative

The differences between prior authorization representatives and representatives can be seen in a few details. Each job has different responsibilities and duties. While it typically takes 2-4 years to become a prior authorization representative, becoming a representative takes usually requires 6-12 months. Additionally, a prior authorization representative has an average salary of $38,726, which is higher than the $36,023 average annual salary of a representative.

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

Prior authorization representative vs representative overview

	Prior Authorization Representative	Representative
Yearly salary	$38,726	$36,023
Hourly rate	$18.62	$17.32
Growth rate	-4%	-4%
Number of jobs	55,498	252,761
Job satisfaction	-	5
Most common degree	High School Diploma, 24%	Bachelor's Degree, 53%
Average age	40	40
Years of experience	4	12

Prior authorization representative vs representative salary

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

	Prior Authorization Representative	Representative
Average salary	$38,726	$36,023
Salary range	Between $29,000 And $51,000	Between $23,000 And $55,000
Highest paying City	Attleboro, MA	Washington, DC
Highest paying state	Massachusetts	New York
Best paying company	NTT Data International L.L.C.	Google
Best paying industry	Health Care	Transportation

Differences between prior authorization representative and representative education

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

	Prior Authorization Representative	Representative
Most common degree	High School Diploma, 24%	Bachelor's Degree, 53%
Most common major	Business	Business
Most common college	Howard University	-

Prior authorization representative vs representative demographics

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

	Prior Authorization Representative	Representative
Average age	40	40
Gender ratio	Male, 21.1% Female, 78.9%	Male, 41.8% Female, 58.2%
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, 11.0% Unknown, 5.4% Hispanic or Latino, 20.9% Asian, 7.5% White, 54.4% American Indian and Alaska Native, 0.7%
LGBT Percentage	7%	7%

Differences between prior authorization representative and 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.

Representative example responsibilities.

Manage fitting rooms and recover the department, while providing exceptional customer service and offering rewards and POS options.
Manage physical portfolio with necessary derivatives to mitigate risk within company guidelines.
Conduct telephone sales and interviews, compile and enter information into database, manage documents and insure customer satisfaction.
Review EOB denials, appeals and/or rebilling as appropriate.
Certify of all requirements, policies, and procedures, including MSB.
Take inbound phone calls from member and providers explaining the EOB denial and payments

Prior authorization representative vs 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 representative skills

Cleanliness, 20%
Patients, 11%
Customer Issues, 10%
Customer Service, 10%
Data Entry, 6%
Outbound Calls, 3%

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Prior Authorization Representative
Prior Authorization Representative vs Representative

Updated January 8, 2025

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