What These Numbers Mean for You
Your prior authorization processors are 66% automatable on average — meaning roughly two-thirds of their daily work involves rule-following tasks that software can handle reliably.
What that automatable portion looks like: Checking eligibility criteria against payer rules, pulling patient data from EMR systems, submitting requests through portals, tracking status, sending fax transmissions, and logging outcomes. These steps are repetitive, structured, and document-heavy — exactly what automation handles well.
What stays human: The remaining third requires genuine judgment. Think peer-to-peer calls with physicians, handling denials with unusual clinical circumstances, navigating payer disputes, and managing urgent cases where a patient is waiting on care. Relationships with provider offices and payers also matter — a frustrated doctor's office needs a person, not a bot.
The honest reality: At $31,250–$43,500 annually, this role carries meaningful labor cost. Automating the routine frees your staff to focus where human judgment actually protects patients and reversal rates — the work that can't be templated.
Based on 10 postings our engine analyzed · updated .