Prior Authorization Specialist Jobs
Prior Authorization Specialist jobs are open across healthcare systems, insurance carriers, specialty pharmacies, and managed care organizations, from entry-level to senior and lead, with specializations in medical, dental, and pharmacy prior authorization. Scan the live roles below and apply to whichever ones fit.
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Neuroscience Group is growing! We have a newly created position on our Prior Authorization and scheduling team that works primarily with Interventional Radiology. This position will work Monday - Friday 8 hours per day. As an integral member of the Patient Access Team, the Interventional Radiology (IR) Scheduling/Authorization Specialist will both schedule and obtain prior authorization for Interventional Radiology procedures performed by Neuroscience Group Interventional Radiologist taking place in partner hospital settings.
For over thirty years, Neuroscience Group has provided excellent neurologic care for the Fox Valley and Northeast Wisconsin. Ours is the only medical facility in the area that combines neurosurgery, neurology, orthopedic spine surgery, interventional and non-interventional pain management and physical therapy. Our practice has grown to over 50 providers and serves patients in nine outlying clinics scattered throughout the region. Our mission is to improve lives by providing the very best in brain, spine and pain care and we do that by living our company core values: compassionate care, teamwork, fiscal responsibility, continuous learning, leadership and community involvement.
RESPONSIBILITIES:
Prior Authorization:
- Verifies and reviews all patient insurance information as it applies to the pre-certification process
- Verifies correct CPT and DX codes for the requested procedure(s)
- Determine necessity for pre-authorization
- Reviews chart documentation to ensure patient meets medical policy guidelines
- Obtains authorization via payer website, phone or fax form depending on insurance requirements
- Communicates with the involved parties regarding benefit eligibility and other financial issues
- Notifies patients and practitioners of any services requested and/or referred that are not authorized by insurance; schedules Peer to Peer consults for denied authorizations
- Assists with submission of appeal letters/clinicals if needed
- Follows up regularly on pending cases
- Responds to both written and oral correspondence regarding scheduling changes/cancellations in a timely and accurate manner
Interventional Radiology Scheduling
- Schedule hospital-based IR procedures for patients with appropriate provider and facility using computerized scheduling programs
- Uses Epic chat and Google Doc program to communicate scheduling of procedures
- Informs equipment representatives of upcoming procedure, providing accurate facility location, date and time, and any changes that occur
- Schedule all preoperative and postoperative appointments regarding the procedure
- Completes and faxes any required pre op testing orders to appropriate locations if applicable
- Confirms procedure authorization is valid and informs IR authorization representative if update is necessary
- Answers incoming calls and schedules/confirms patient procedures, along with any related appointments using proper telephone etiquette
- Coordinates the related documentation and communication, including adding important details to education letter in Epic to be finished by IR triage team
KNOWLEDGE/SKILLS REQUIRED TO BE SUCCESSFUL IN THIS POSITION
- Previous experience in medical preauthorization/precertification required
- Surgery authorization preferred
- Previous procedure scheduling experience preferred
- Knowledge of health care insurance and third-party payers. (commercial, Medicare/Medicaid, VA, Work Comp, etc.)
- Previous experience with CPT and ICD-10 coding
- Prior EPIC experience preferred
- Proficient computer knowledge and keyboarding skills (Microsoft Office programs)
- Medical terminology
- Excellent verbal and written communication skills
- Customer service experience
- Strong organizational skills
- Detail-oriented
- Ability to multi-task and remain focused while managing a high-volume, time-sensitive workload
- Critical thinking skills and decisive judgment
TYPICAL PHYSICAL DEMANDS AND WORKING CONDITIONS
- Primarily seated work but will require some position change including bending, stooping, and stretching.
- May involve lifting supplies up to 20 to 30 pounds.
- May occasionally need to assist with wheelchair transfers.
- Requires hand-eye coordination and manual dexterity sufficient to operate standard office equipment.
- Requires normal range of hearing and eyesight in order to communicate and function within this setting.
BENEFITS
At Neuroscience Group we offer a very competitive salary. In addition to great pay we also offer the following benefits:
- No nights, no weekends, and no holidays!
- Health Insurance
- Health Savings Accounts with a generous employer contribution
- Dental Insurance
- Vision Insurance
- Company paid Long Term Disability and Life Insurance
- Voluntary Life and Short Term Disability Insurance
- Voluntary Accident and Critical Illness Insurance
- Generous PTO and Sick Banks
- 401(k) with guaranteed employer contribution, Profit Sharing, and a Cash Balance Pension Plan
- Employee Assistance Program
- Timber Rattler tickets
- Holiday party, summer picnic, and annual recognition for years of service
- Annual Employee Appreciation Day
Neuroscience Group is growing! We have a newly created position on our Prior Authorization and scheduling team that works primarily with Interventional Radiology. This position will work Monday - Friday 8 hours per day. As an integral member of the Patient Access Team, the Interventional Radiology (IR) Scheduling/Authorization Specialist will both schedule and obtain prior authorization for Interventional Radiology procedures performed by Neuroscience Group Interventional Radiologist taking place in partner hospital settings.
For over thirty years, Neuroscience Group has provided excellent neurologic care for the Fox Valley and Northeast Wisconsin. Ours is the only medical facility in the area that combines neurosurgery, neurology, orthopedic spine surgery, interventional and non-interventional pain management and physical therapy. Our practice has grown to over 50 providers and serves patients in nine outlying clinics scattered throughout the region. Our mission is to improve lives by providing the very best in brain, spine and pain care and we do that by living our company core values: compassionate care, teamwork, fiscal responsibility, continuous learning, leadership and community involvement.
RESPONSIBILITIES:
Prior Authorization:
- Verifies and reviews all patient insurance information as it applies to the pre-certification process
- Verifies correct CPT and DX codes for the requested procedure(s)
- Determine necessity for pre-authorization
- Reviews chart documentation to ensure patient meets medical policy guidelines
- Obtains authorization via payer website, phone or fax form depending on insurance requirements
- Communicates with the involved parties regarding benefit eligibility and other financial issues
- Notifies patients and practitioners of any services requested and/or referred that are not authorized by insurance; schedules Peer to Peer consults for denied authorizations
- Assists with submission of appeal letters/clinicals if needed
- Follows up regularly on pending cases
- Responds to both written and oral correspondence regarding scheduling changes/cancellations in a timely and accurate manner
Interventional Radiology Scheduling
- Schedule hospital-based IR procedures for patients with appropriate provider and facility using computerized scheduling programs
- Uses Epic chat and Google Doc program to communicate scheduling of procedures
- Informs equipment representatives of upcoming procedure, providing accurate facility location, date and time, and any changes that occur
- Schedule all preoperative and postoperative appointments regarding the procedure
- Completes and faxes any required pre op testing orders to appropriate locations if applicable
- Confirms procedure authorization is valid and informs IR authorization representative if update is necessary
- Answers incoming calls and schedules/confirms patient procedures, along with any related appointments using proper telephone etiquette
- Coordinates the related documentation and communication, including adding important details to education letter in Epic to be finished by IR triage team
KNOWLEDGE/SKILLS REQUIRED TO BE SUCCESSFUL IN THIS POSITION
- Previous experience in medical preauthorization/precertification required
- Surgery authorization preferred
- Previous procedure scheduling experience preferred
- Knowledge of health care insurance and third-party payers. (commercial, Medicare/Medicaid, VA, Work Comp, etc.)
- Previous experience with CPT and ICD-10 coding
- Prior EPIC experience preferred
- Proficient computer knowledge and keyboarding skills (Microsoft Office programs)
- Medical terminology
- Excellent verbal and written communication skills
- Customer service experience
- Strong organizational skills
- Detail-oriented
- Ability to multi-task and remain focused while managing a high-volume, time-sensitive workload
- Critical thinking skills and decisive judgment
TYPICAL PHYSICAL DEMANDS AND WORKING CONDITIONS
- Primarily seated work but will require some position change including bending, stooping, and stretching.
- May involve lifting supplies up to 20 to 30 pounds.
- May occasionally need to assist with wheelchair transfers.
- Requires hand-eye coordination and manual dexterity sufficient to operate standard office equipment.
- Requires normal range of hearing and eyesight in order to communicate and function within this setting.
BENEFITS
At Neuroscience Group we offer a very competitive salary. In addition to great pay we also offer the following benefits:
- No nights, no weekends, and no holidays!
- Health Insurance
- Health Savings Accounts with a generous employer contribution
- Dental Insurance
- Vision Insurance
- Company paid Long Term Disability and Life Insurance
- Voluntary Life and Short Term Disability Insurance
- Voluntary Accident and Critical Illness Insurance
- Generous PTO and Sick Banks
- 401(k) with guaranteed employer contribution, Profit Sharing, and a Cash Balance Pension Plan
- Employee Assistance Program
- Timber Rattler tickets
- Holiday party, summer picnic, and annual recognition for years of service
- Annual Employee Appreciation Day
See All 152+ Prior Authorization Specialist Jobs
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Who's Hiring
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What Employers Look For
The qualifications that appear most often in prior authorization specialist jobs.
- One to three years of prior authorization or insurance verification experience in a clinical setting
- Proficiency with electronic health record systems and payer web portals
- Knowledge of ICD-10 and CPT coding as applied to authorization requests
- Familiarity with medical necessity criteria and clinical decision-support guidelines such as InterQual or MCG
- Strong written and verbal communication skills for peer-to-peer reviews and denial appeals
- High school diploma or equivalent required, associate or bachelor's degree in a health-related field preferred
Tips for Your Prior Authorization Specialist Job Search
Tailor your resume to payer-specific language
Highlight the specific payers you've worked with, such as Medicare Advantage, Medicaid, or commercial plans. Recruiters scan for payer familiarity fast, so naming them directly in your work history beats generic phrases like 'insurance experience.'
List your authorization platforms by name
Employers filter for candidates who already know their systems. Name every platform you've used, including payer portals, clinical decision-support tools, and electronic health record modules, so your resume passes automated screening before a human ever reads it.
Apply early to roles that fit
Migrate Mate lists prior authorization specialist openings from across the United States in one place, so you can find roles that match and apply directly to each listing.
Target postings by clinical specialty worked
Filter openings by the specialty you know best, whether oncology, behavioral health, durable medical equipment, or infusion therapy. Specialty-specific experience is a real differentiator, and hiring managers notice when your background aligns with their patient population.
Prepare for clinical scenario questions in interviews
Interviewers often walk through a denial scenario and ask how you'd handle the appeal. Walk through your process for gathering supporting documentation, citing clinical criteria, and escalating to a physician reviewer so your answer sounds practiced, not improvised.
Negotiate start date around credentialing timelines
If a role requires payer credentialing or system access setup before you can process authorizations independently, build that into your start-date conversation. Asking about onboarding access upfront signals you understand the operational reality of the role.
Prior Authorization Specialist Jobs: Frequently Asked Questions
Which companies are hiring the most prior authorization specialists?
assist point, NYX Health, and Shields Health Solutions are hiring the most prior authorization specialists right now, with openings concentrated in Texas, New York, and Florida, based on current listings on Migrate Mate as of November 2026. High-volume hiring tends to cluster at large health systems, managed care organizations, and specialty pharmacy benefit managers.
How many prior authorization specialist jobs are remote?
About 55% of prior authorization specialist openings are fully remote or hybrid as of November 2026, reflecting strong demand for phone- and portal-based work that doesn't require an on-site presence. Pharmacy prior authorization and behavioral health authorization roles tend to have the highest share of fully remote positions.
How do you become a prior authorization specialist?
Start by gaining experience in medical billing, insurance verification, or a clinical support role that exposes you to payer communication and coding. Learn ICD-10 and CPT codes, get comfortable with electronic health record systems, and study how payers apply clinical criteria like InterQual or MCG. Many employers will train candidates who bring strong attention to detail and healthcare administrative experience even without a direct prior authorization background.
Can you get a prior authorization specialist job with little experience?
Yes, many employers hire candidates with limited direct experience if they have a background in medical reception, billing, or patient services. Focus on roles labeled 'prior authorization coordinator' or 'authorization assistant,' which often carry lighter experience requirements. Demonstrating comfort with payer portals, medical terminology, and high-volume administrative work closes the gap faster than credentials alone.
What does the prior authorization specialist interview process look like?
Most interviews include a phone screen with a recruiter, followed by one or two video or in-person rounds with a supervisor or team lead. Expect scenario-based questions about handling denials, managing high caseloads, and working across clinical and billing teams. Some employers include a short skills assessment covering coding knowledge or a mock authorization workflow to gauge practical familiarity.
Where can I find and apply to prior authorization specialist jobs?
You can find and apply to prior authorization specialist jobs on Migrate Mate, which lists current openings from across the United States. Search for roles that match your specialty background, payer experience, or preferred work setting, and apply directly to each listing that fits.
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