Prior authorization specialist vs specialist

The differences between prior authorization specialists and specialists 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 specialist, becoming a specialist takes usually requires 1-2 years. Additionally, a specialist has an average salary of $58,013, which is higher than the $36,120 average annual salary of a prior authorization specialist.

The top three skills for a prior authorization specialist include patients, customer service and medical necessity. The most important skills for a specialist are patients, customer service, and work ethic.

Prior authorization specialist vs specialist overview

	Prior Authorization Specialist	Specialist
Yearly salary	$36,120	$58,013
Hourly rate	$17.37	$27.89
Growth rate	-4%	10%
Number of jobs	69,667	358,433
Job satisfaction	5	-
Most common degree	Bachelor's Degree, 32%	Bachelor's Degree, 49%
Average age	40	42
Years of experience	4	2

What does a prior authorization specialist do?

Prior Authorization Specialists are individuals responsible for the entire process of prior authorization for a client. They manage communication between stakeholders of clients, healthcare providers, and insurance companies to request for prior authorizations. Their duties include ensuring complete and updated patient and claim documentation, performing daily billings, auditing accounts for accurate submissions claim, and making sure patient treatment reimbursements are processed effectively. Prior Authorization Specialists also review outstanding accounts and handle reimbursement or billing issues to ensure clean billing claims.

What does a specialist do?

Specialists are employees who are responsible for specific tasks or activities in the department they are assigned to. The actions or tasks they work on are related to their educational background or work experiences. They are usually highly skilled in specializations related to the work they are assigned to. Specialists are also highly trained on the competencies that are required of their specialty. As such, they are focused on the skills and competencies that are needed to enhance their experience in their specific field further.

Prior authorization specialist vs specialist salary

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

	Prior Authorization Specialist	Specialist
Average salary	$36,120	$58,013
Salary range	Between $27,000 And $46,000	Between $32,000 And $104,000
Highest paying City	Framingham, MA	Jersey City, NJ
Highest paying state	Massachusetts	New Jersey
Best paying company	Washington State University	The Citadel
Best paying industry	Health Care	-

Differences between prior authorization specialist and specialist education

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

	Prior Authorization Specialist	Specialist
Most common degree	Bachelor's Degree, 32%	Bachelor's Degree, 49%
Most common major	Nursing	Business
Most common college	University of Southern California	Stanford University

Prior authorization specialist vs specialist demographics

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

	Prior Authorization Specialist	Specialist
Average age	40	42
Gender ratio	Male, 18.4% Female, 81.6%	Male, 47.5% Female, 52.5%
Race ratio	Black or African American, 9.2% Unknown, 5.3% Hispanic or Latino, 23.0% Asian, 6.9% White, 54.9% American Indian and Alaska Native, 0.7%	Black or African American, 11.4% Unknown, 5.4% Hispanic or Latino, 16.4% Asian, 10.5% White, 55.9% American Indian and Alaska Native, 0.4%
LGBT Percentage	7%	11%

Differences between prior authorization specialist and specialist duties and responsibilities

Prior authorization specialist example 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.

Specialist example responsibilities.

Create, manage, and assist users with SharePoint sites.
Manage an on-site IRB and company good clinical practice (GCP) inspection.
Manage SharePoint sites by creating, editing, and customizing company sites, libraries and security.
Manage the building of accounts, assigning of static IP's, and scheduling of business class installations.
Convert servers from UNIX to Linux, all hardware diagnostics and repair including printers/plotters/desktops etc.
Follow safety procedures such as maintenance of all equipment (Telxon scanners, terminals and ladders).

Prior authorization specialist vs specialist skills

Common prior authorization specialist skills

Patients, 18%
Customer Service, 8%
Medical Necessity, 8%
Medical Terminology, 6%
Clinical Resource, 6%
Authorization Process, 4%

Common specialist skills

Patients, 15%
Customer Service, 11%
Work Ethic, 5%
Patient Care, 4%
Exceptional Client, 4%
Troubleshoot, 4%

Prior Authorization Specialist vs. similar jobs

Prior Authorization Specialist related careers

Prior Authorization Specialist related jobs

What similar roles do

Zippia Careers
Office and Administrative Industry
Prior Authorization Specialist
Prior Authorization Specialist vs Specialist

Updated January 8, 2025

Browse office and administrative jobs