How to hire a prior authorization specialist

How to hire a prior authorization specialist, step by step

Here's a step-by-step prior authorization specialist hiring guide:

• Step 1: Identify your hiring needs
• Step 2: Create an ideal candidate profile
• Step 3: Make a budget
• Step 4: Write a prior authorization specialist job description
• Step 5: Post your job
• Step 6: Interview candidates
• Step 7: Send a job offer and onboard your new prior authorization specialist
• Step 8: Go through the hiring process checklist

What does a prior authorization specialist do?

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1. Identify your hiring needs

   Before you start hiring a prior authorization specialist, identify what type of worker you actually need. Certain positions might call for a full-time employee, while others can be done by a part-time worker or contractor.

   Determine employee vs contractor status

   Is the person you're thinking of hiring a US citizen or green card holder?

   Yes

   No

   A prior authorization specialist's background is also an important factor in determining whether they'll be a good fit for the position. For example, prior authorization specialists from different industries or fields will have radically different experiences and will bring different viewpoints to the role. You also need to consider the candidate's previous level of experience to make sure they'll be comfortable with the job's level of seniority.

   This list presents prior authorization specialist salaries for various positions.

   Type of Prior Authorization Specialist	Description	Hourly rate
   Prior Authorization Specialist	Customer service representatives interact with customers to handle complaints, process orders, and provide information about an organization’s products and services.	$12-22
   Biller	Billers are medical professionals who are responsible for translating health care services into medical claims to be submitted to insurance companies. These billers are required to obtain patient medical records and interpret them to determine the billable units and services... Show more	$13-23
   Medical Billing Clerk	A medical billing clerk is primarily in charge of processing payments and creating billing arrangements in clinics and hospitals. Among their responsibilities include gathering and verifying patient identification, handling insurance information, coding, updating databases, and maintaining records... Show more	$12-19

   Show more

2. Create an ideal candidate profile

   Common skills:

   • Patients
   • Customer Service
   • Medical Necessity
   • Medical Terminology
   • Clinical Resource
   • Authorization Process
   • Data Entry
   • Utilization Management
   • CPT
   • Authorization Request
   • Medicaid
   • Appeals
   • Patient Care
   • Outbound Calls

   Check all skills

   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.
   • Register patients into the emergency department or outpatients for surgery or procedures.
   • Register patients' demographics and insurance information; execute daily outpatient and surgery reports.

   More prior authorization specialist duties

3. Make a budget

   Including a salary range in your prior authorization specialist job description is a great way to entice the best and brightest candidates. A prior authorization specialist salary can vary based on several factors:

   • Location. For example, prior authorization specialists' average salary in louisiana is 50% less than in massachusetts.
   • Seniority. Entry-level prior authorization specialists earn 41% less than senior-level prior authorization specialists.
   • Certifications. A prior authorization specialist with a few certifications under their belt will likely demand a higher salary.
   • Company. Working for a prestigious company or an exciting start-up can make a huge difference in a prior authorization specialist's salary.

   Average prior authorization specialist salary

   $36,120yearly

   $17.37 hourly rate

   ---

   Entry-level prior authorization specialist salary

   $27,000 yearly salary

   Updated December 16, 2025

   Average prior authorization specialist salary by state

   Rank	State	Avg. salary	Hourly rate
   1	Massachusetts	$49,980	$24
   2	Illinois	$41,358	$20
   3	New York	$40,804	$20
   4	Minnesota	$40,585	$20
   5	Connecticut	$40,169	$19
   6	New Jersey	$39,143	$19
   7	Pennsylvania	$37,445	$18
   8	California	$37,099	$18
   9	Wisconsin	$36,050	$17
   10	Washington	$33,778	$16
   11	Oregon	$32,866	$16
   12	Ohio	$32,345	$16
   13	Arizona	$31,279	$15
   14	North Carolina	$31,267	$15
   15	Colorado	$30,637	$15
   16	Indiana	$30,497	$15
   17	Georgia	$30,327	$15
   18	Texas	$30,161	$15
   19	Florida	$29,187	$14
   20	Arkansas	$28,048	$13

   Average prior authorization specialist salary by company

   Company

   Rank	Company	Average salary	Hourly rate	Job openings
   1	Washington State University	$42,800	$20.58
   2	Talyst	$40,796	$19.61
   3	Treasure Coast Community Health	$39,223	$18.86
   4	Inspire Medical Systems	$38,797	$18.65	3
   5	University of Rochester	$38,358	$18.44	30
   6	CVS Health	$38,050	$18.29	54
   7	Maine Health/maine Mental Health Partners	$38,017	$18.28	85
   8	Emerson Hospital	$36,742	$17.66	7
   9	Sonic Healthcare USA	$35,946	$17.28	9
   10	ICONMA	$35,931	$17.27
   11	Wps Health Insurance	$35,872	$17.25	1
   12	Saratoga Hospital	$35,826	$17.22	10
   13	Doctors Medical Ctr	$35,592	$17.11	2
   14	Yukon Kuskokwim Health	$35,376	$17.01
   15	Colorado Canyons Hospital & Medical Center	$35,289	$16.97
   16	Fresenius Medical Care North America Holdings Limited Partnership	$35,240	$16.94	26
   17	Meridian Health Services	$35,077	$16.86
   18	St Luke's Hospital & Health Network Inc	$35,009	$16.83
   19	East Boston Neighborhood Health Center	$34,859	$16.76
   20	Gundersen Lutheran Medical Foundation Inc.	$34,804	$16.73	19

4. Writing a prior authorization specialist job description

   A prior authorization specialist job description should include a summary of the role, required skills, and a list of responsibilities. It's also good to include a salary range and the first name of the hiring manager. Below, you can find an example of a prior authorization specialist job description:

   Prior authorization specialist job description example

   This position is responsible for scheduling patient treatments or diagnostic procedures for assigned area. Activities include pre-registration; receiving physician orders, insurance verification, gathering preauthorizations and pre-certifications. Maintains records and produces statistical reports as required. May distribute educational materials to patients and families if needed in assigned department.
   About Fairbanks Memorial Hospital
   Fairbanks Memorial Hospital is a non-profit facility owned by the Greater Fairbanks Community Hospital Foundation. A Joint Commission-accredited facility with 152 licensed beds, Fairbanks Memorial Hospital is the primary referral center for residents of Alaska's interior with a strong patient-to-nurse ratio and Shared Leadership Infrastructure. In addition to our exceptional clinical environment, our location offers incomparable lifestyle rewards away from work. In Fairbanks, small-town living, spectacular natural beauty and endless recreation combine to create a one-of-a-kind place to live, work and play.
   Responsibilities Receives physician orders and seeks clarification, if necessary. Verifies insurance, obtains preauthorizations and per-certifications. Answers all telephone inquiries related to scheduling. Schedules patients for treatments or diagnostic procedures using computerized scheduling systems. Resolves scheduling conflicts, as needed. Documents all information regarding patient re-schedules. Enters patient information in computerized scheduling system and gathers information and modifies records, as needed to maintain current database. Prepares charts and manages files within regulatory requirements. Compiles and reports statistical data, if needed by the assigned department. Distributes educational materials to patients and families, when necessary. Responds to diverse questions or refers to appropriate clinical staff. Provides administrative support to the assigned unit when required. Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Foundation Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day. Qualifications
   High school diploma/GED or equivalent working knowledge.
   
   The position also requires skills and abilities typically attained with 2 years of medical clerical experience; preferably in a hospital central scheduling or physician office scheduling setting. Medical terminology is required. Must possess excellent organizational skills, as well as effective human relations and communication skills.
   
   Must be proficient with commonly used office software and computers and possess the ability to use computerized scheduling systems. Must be able to maintain accurate statistical records, gather data, and produce reports.
   
   PREFERRED QUALIFICATIONS
   Additional related education and/or experience preferred. Foundation Health Partners is an EEO/AAP employer; q qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. We can recommend jobs specifically for you! Click here to get started.

   Copy this example

   

5. Post your job

   To find the right prior authorization specialist for your business, consider trying out a few different recruiting strategies:

   • Consider internal talent. One of the most important sources of talent for any company is its existing workforce.
   • Ask for referrals. Reach out to friends, family members, and current employees and ask if they know or have worked with prior authorization specialists they would recommend.
   • Recruit at local colleges. Attend job fairs at local colleges to recruit prior authorization specialists who meet your education requirements.
   • Social media platforms. LinkedIn, Facebook and Twitter now have more than 3.5 billion users, and you can use social media to reach potential job candidates.

   Post your job online:

   • Post your prior authorization specialist job on Zippia to find and recruit prior authorization specialist candidates who meet your exact specifications.
   • Use field-specific websites.
   • Post a job on free websites.

6. Interview candidates

   To successfully recruit prior authorization specialists, your first interview needs to engage with candidates to learn about their interest in the role and experience in the field. You can go into more detail about the company, the role, and the responsibilities during follow-up interviews.

   It's also good to ask about candidates' unique skills and talents. You can move on to the technical interview if a candidate is good enough for the next step.

   The right interview questions can help you assess a candidate's hard skills, behavioral intelligence, and soft skills.

7. Send a job offer and onboard your new prior authorization specialist

   Once you've found the prior authorization specialist candidate you'd like to hire, it's time to write an offer letter. This should include an explicit job offer that includes the salary and the details of any other perks. Qualified candidates might be looking at multiple positions, so your offer must be competitive if you like the candidate. Also, be prepared for a negotiation stage, as candidates may way want to tweak the details of your initial offer. Once you've settled on these details, you can draft a contract to formalize your agreement.

   It's also good etiquette to follow up with applicants who don't get the job by sending them an email letting them know that the position has been filled.

   After that, you can create an onboarding schedule for a new prior authorization specialist. Human Resources and the hiring manager should complete Employee Action Forms. Human Resources should also ensure that onboarding paperwork is completed, including I-9s, benefits enrollment, federal and state tax forms, etc., and that new employee files are created.

8. Go through the hiring process checklist

   • Determine employee type (full-time, part-time, contractor, etc.)
   • Submit a job requisition form to the HR department
   • Define job responsibilities and requirements
   • Establish budget and timeline
   • Determine hiring decision makers for the role
   • Write job description
   • Post job on job boards, company website, etc.
   • Promote the job internally
   • Process applications through applicant tracking system
   • Review resumes and cover letters
   • Shortlist candidates for screening
   • Hold phone/virtual interview screening with first round of candidates
   • Conduct in-person interviews with top candidates from first round
   • Score candidates based on weighted criteria (e.g., experience, education, background, cultural fit, skill set, etc.)
   • Conduct background checks on top candidates
   • Check references of top candidates
   • Consult with HR and hiring decision makers on job offer specifics
   • Extend offer to top candidate(s)
   • Receive formal job offer acceptance and signed employment contract
   • Inform other candidates that the position has been filled
   • Set and communicate onboarding schedule to new hire(s)
   • Complete new hire paperwork (i9, benefits enrollment, tax forms, etc.)

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How much does it cost to hire a prior authorization specialist?