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Working As a Prior Authorization Specialist

  • Documenting/Recording Information
  • Performing for or Working Directly with the Public
  • Getting Information
  • Assisting and Caring for Others
  • Establishing and Maintaining Interpersonal Relationships
  • Deal with People

  • Unpleasant/Angry People

  • $45,000

    Average Salary

What Does A Prior Authorization Specialist Do

Customer service representatives interact with customers to handle complaints, process orders, and provide information about an organization’s products and services.

Duties

Customer service representatives typically do the following:

  • Listen to customers’ questions and concerns, and provide answers or responses
  • Provide information about products and services
  • Take orders, calculate charges, and process billing or payments
  • Review or make changes to customer accounts
  • Handle returns or complaints
  • Record details of customer contacts and actions taken
  • Refer customers to supervisors or more experienced employees

Customer service representatives answer questions or requests from customers or the public. They typically provide services by phone, but some also interact with customers face to face, by email, or live chat.

The specific duties of customer service representatives vary by industry. For example, representatives who work in banks may answer customers’ questions about their accounts. Representatives who work for utility and communication companies may help customers with service problems, such as outages. Those who work in retail stores often handle returns, process refunds, and help customers locate items. Some representatives make changes to customers’ accounts, such as updating addresses or canceling orders. Although selling is not their main job, some representatives may help generate sales while providing information about a product or service.

Customer service representatives typically use a telephone, computer, and other office equipment. For example, representatives who work in call centers answer phone calls and use computers to review and select standard responses from a list of options. Those employed in retail stores use registers to process returns or orders.

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How To Become A Prior Authorization Specialist

Customer service representatives typically need a high school diploma and receive on-the-job training to learn the specific skills needed for the job. They should be good at communicating and interacting with people and have some experience using computers.

Education

Customer service representatives typically need a high school diploma.

Training

Customer service representatives usually receive short-term on-the-job training, lasting 2 to 3 weeks. Those who work in finance and insurance may need several months of training to learn more complicated financial regulations.

General customer-service training may focus on procedures for answering questions, information about a company’s products and services, and computer and telephone use. Trainees often work under the guidance of an experienced worker for the first few weeks of employment.

In certain industries, such as finance and insurance, customer service representatives must remain current with changing regulations.

Licenses, Certifications, and Registrations

Customer service representatives who provide information about finance and insurance may need a state license. Although licensing requirements vary by state, they usually include passing a written exam. Some employers and organizations may provide training for these exams.

Important Qualities

Communication skills. Customer service representatives must be able to provide information in writing, by phone, or in person so that customers can understand them.

Customer-service skills. Representatives help companies retain customers by answering their questions and complaints in a helpful and professional manner.

Interpersonal skills. Representatives should be able to create positive interactions with customers.

Listening skills. Representatives must listen carefully and understand a customer’s situation in order to assist them.

Patience. Representatives should be patient and polite, especially when interacting with dissatisfied customers.

Problem-solving skills. Representatives must determine solutions to a customer’s problem. By resolving issues effectively, representatives contribute to customer loyalty and retention.

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Prior Authorization Specialist Career Paths

Prior Authorization Specialist
Pharmacist Manager
Office Manager
5 Yearsyrs
Pharmacist Manager Sales Manager
Account Manager
5 Yearsyrs
Pharmacist Manager Owner
Co-Owner
6 Yearsyrs
Staff Pharmacist Lead Pharmacist Technician Assistant Manager
Center Manager
6 Yearsyrs
Staff Pharmacist Pharmacist Manager Operations Manager
Practice Manager
9 Yearsyrs
Staff Pharmacist Owner Program Director
Clinical Director
9 Yearsyrs
Utilization Review Nurse Case Manager Registered Nurse Case Manager
Nursing Director
9 Yearsyrs
Utilization Review Nurse Case Manager
Director Of Social Services
6 Yearsyrs
Utilization Review Nurse Case Manager Nursing Director
Clinical Services Director
11 Yearsyrs
Team Leader Supervisor Office Manager
Business Office Manager
7 Yearsyrs
Team Leader Store Manager Office Manager
Billing Manager
7 Yearsyrs
Team Leader Office Manager
Accounts Receivable Manager
6 Yearsyrs
Lead Pharmacist Technician Pharmacist Manager Operations Manager
Client Services Manager
7 Yearsyrs
Lead Pharmacist Technician Supervisor Clinical Supervisor
Clinical Manager
8 Yearsyrs
Patient Care Coordinator Registered Nurse Case Manager
Patient Care Manager
5 Yearsyrs
Patient Care Coordinator Registered Nurse Case Manager Registered Nurse Manager
Nurse Manager
9 Yearsyrs
Patient Care Coordinator Supervisor Training Manager
Call Center Manager
6 Yearsyrs
Reimbursement Specialist Medical Coder Billing Manager
Revenue Manager
8 Yearsyrs
Reimbursement Specialist Medical Coder
Billing Supervisor
6 Yearsyrs
Benefit Specialist Customer Service Supervisor Office Supervisor
Supervisor, Patient Access
6 Yearsyrs
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Average Length of Employment
Specialist 2.6 years
Top Careers Before Prior Authorization Specialist
Cashier 6.5%
Nurse 3.4%
Pharmacist 2.5%
Internship 2.2%
Top Careers After Prior Authorization Specialist
Pharmacist 3.9%
Specialist 3.4%
Cashier 3.3%
Nurse 3.1%

Do you work as a Prior Authorization Specialist?

Average Yearly Salary
$45,000
Show Salaries
$27,000
Min 10%
$45,000
Median 50%
$45,000
Median 50%
$45,000
Median 50%
$45,000
Median 50%
$45,000
Median 50%
$45,000
Median 50%
$45,000
Median 50%
$76,000
Max 90%
Best Paying Company
Franciscan Health
Highest Paying City
New York, NY
Highest Paying State
New York
Avg Experience Level
1.8 years
How much does a Prior Authorization Specialist make at top companies?
The national average salary for a Prior Authorization Specialist in the United States is $45,708 per year or $22 per hour. Those in the bottom 10 percent make under $27,000 a year, and the top 10 percent make over $77,000.

Top Skills for A Prior Authorization Specialist

  1. Insurance Companies
  2. Pharmacy Benefits
  3. Customer Service
You can check out examples of real life uses of top skills on resumes here:
  • Obtained prior authorizations from various insurance companies by submitting clinical information via fax or speaking directly to a case management representative.
  • Coordinate needed therapy for patients through vigilant and positive mediation between doctor's office and pharmacy benefits manager/ health insurance.
  • Maintained excellent customer service for all in-bound calls from medical providers and pharmacies requesting prior authorizations for prescription medications.
  • Coordinated with medical offices to approve patients for prescription assistance program.
  • Handle telephone calls timely and accurately.

Rank:

Average Salary:

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Top 10 Best States for Prior Authorization Specialists

  1. Rhode Island
  2. Massachusetts
  3. Delaware
  4. New York
  5. Pennsylvania
  6. Ohio
  7. Michigan
  8. New Hampshire
  9. New Jersey
  10. Wisconsin
  • (58 jobs)
  • (380 jobs)
  • (42 jobs)
  • (557 jobs)
  • (533 jobs)
  • (593 jobs)
  • (449 jobs)
  • (62 jobs)
  • (308 jobs)
  • (220 jobs)

Prior Authorization Specialist Resume Examples And Tips

The average resume reviewer spends between 5 to 7 seconds looking at a single resume, which leaves the average job applier with roughly six seconds to make a killer first impression. Thanks to this, a single typo or error on your resume can disqualify you right out of the gate. At Zippia, we went through over 2,691 Prior Authorization Specialist resumes and compiled some information about how best to optimize them. Here are some suggestions based on what we found, divided by the individual sections of the resume itself.

Learn How To Create A Top Notch Prior Authorization Specialist Resume

View Resume Examples

Prior Authorization Specialist Demographics

Gender

Female

70.6%

Male

15.6%

Unknown

13.7%
Ethnicity

White

61.0%

Hispanic or Latino

19.7%

Black or African American

9.4%

Asian

6.6%

Unknown

3.4%
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Foreign Languages Spoken

Spanish

63.5%

Chinese

3.2%

Romanian

3.2%

Hindi

3.2%

Mandarin

3.2%

Russian

1.6%

Portuguese

1.6%

Samoan

1.6%

Filipino

1.6%

Vietnamese

1.6%

Japanese

1.6%

French

1.6%

Amharic

1.6%

Gujarati

1.6%

Cantonese

1.6%

Urdu

1.6%

Korean

1.6%

Arabic

1.6%

Thai

1.6%

Italian

1.6%
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Prior Authorization Specialist Education

Schools

University of Phoenix

21.2%

Arizona State University

7.1%

Baker College

5.9%

Pima Community College

5.2%

Remington College

4.8%

Valencia College

4.5%

Charles Stewart Mott Community College

4.5%

Austin Community College

4.5%

Grand Canyon University

4.5%

Ashford University

4.1%

Lindenwood University

4.1%

Mesa Community College - Boswell

3.7%

All American Career College

3.7%

Capella University

3.7%

University of Missouri - Saint Louis

3.3%

Gateway Community College

3.3%

Sinclair Community College

3.3%

Indiana University - Purdue University Indianapolis

3.0%

Tucson College

3.0%

Ultimate Medical Academy - Clearwater

2.6%
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Majors

Nursing

19.6%

Pharmacy

19.5%

Business

14.3%

Health Care Administration

13.6%

Medical Assisting Services

6.6%

General Studies

3.3%

Management

2.6%

Psychology

2.4%

Criminal Justice

2.1%

Biology

2.0%

Accounting

1.9%

Education

1.7%

Medical Technician

1.6%

Computer Information Systems

1.6%

Nursing Assistants

1.4%

Insurance

1.4%

Communication

1.3%

Public Health

1.2%

Human Resources Management

1.1%

Human Services

1.0%
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Degrees

Other

32.3%

Bachelors

25.2%

Associate

16.7%

Certificate

8.3%

Diploma

6.6%

Masters

6.4%

Doctorate

2.4%

License

2.0%
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Internship
Temporary

Top Prior Authorization Specialist Employers

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Updated May 19, 2020