Explore jobs
Find specific jobs
Explore careers
Explore professions
Best companies
Explore companies
What is a prior authorization specialist and how to become one
Prior authorization specialists are responsible for all processes on prior authorization. They stand as an intermediary between the client, healthcare provider, and the insurance company as they help their client get prior authorization from the insurance company that will be needed for approval of certain healthcare services by the healthcare provider. You are in charge of verifying your client's eligibility and benefits, gathering all information and documents required for processing, completing all processes at the right time, and also keeping a record of the account activities.
You must have customer service skills, time management skills, computer literacy, listening skills, communication skills, problem-solving skills, organization skills, and you must be able to interpret data. You need a bachelor's degree in pharmacy, healthcare administration, or a related field to qualify for this role. As a prior authorization specialist, you will earn an average of $35,290 per year.
Avg. Salary $36,120
Avg. Salary $59,228
Growth rate -4%
Growth rate 0.3%
American Indian and Alaska Native 0.70%
Asian 6.88%
Black or African American 9.18%
Hispanic or Latino 23.02%
Unknown 5.30%
White 54.93%
Genderfemale 81.63%
male 18.37%
Age - 39American Indian and Alaska Native 3.00%
Asian 7.00%
Black or African American 14.00%
Hispanic or Latino 19.00%
White 57.00%
Genderfemale 47.00%
male 53.00%
Age - 39Stress level is high
7.1 - high
Complexity level is challenging
7 - challenging
Work life balance is good
6.4 - fair
Prior authorization specialist career paths
Key steps to become a prior authorization specialist
Explore prior authorization specialist education requirements
Start to develop specific prior authorization specialist skills
Skills Percentages Patients 17.70% Customer Service 8.29% Medical Necessity 7.81% Medical Terminology 5.55% Clinical Resource 5.52% Complete relevant prior authorization specialist training and internships
Accountants spend an average of 1-3 months on post-employment, on-the-job training. New prior authorization specialists learn the skills and techniques required for their job and employer during this time. The chart below shows how long it takes to gain competency as a prior authorization specialist based on U.S. Bureau of Labor Statistics data and data from real prior authorization specialist resumes.Research prior authorization specialist duties and 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.
Prepare your prior authorization specialist resume
When your background is strong enough, you can start writing your prior authorization specialist resume.
You can use Zippia's AI resume builder to make the resume writing process easier while also making sure that you include key information that hiring managers expect to see on a prior authorization specialist resume. You'll find resume tips and examples of skills, responsibilities, and summaries, all provided by Zippi, your career sidekick.
Choose from 10+ customizable prior authorization specialist resume templates
Build a professional prior authorization specialist resume in minutes. Browse through our resume examples to identify the best way to word your resume. Then choose from 10+ resume templates to create your prior authorization specialist resume.
Apply for prior authorization specialist jobs
Now it's time to start searching for a prior authorization specialist job. Consider the tips below for a successful job search:
- Browse job boards for relevant postings
- Consult your professional network
- Reach out to companies you're interested in working for directly
- Watch out for job scams
How did you land your first prior authorization specialist job
Are you a prior authorization specialist?
Share your story for a free salary report.
Average prior authorization specialist salary
The average prior authorization specialist salary in the United States is $36,120 per year or $17 per hour. Prior authorization specialist salaries range between $27,000 and $46,000 per year.
What am I worth?
How do prior authorization specialists rate their job?
Prior authorization specialist reviews
helping people get their medication and I like the job itself!
The only thing I dont like is I have a dual job which I am an LPN in an acute psychiatric childrens unit and adults, then I also pre authorize medication for a 100 bed hospital in which I work, so I dont always have the time I need.
Updated January 8, 2025
