What These Numbers Mean for Your Prior Authorization Team
The 65% automatability figure means roughly two-thirds of what your staff does today follows predictable rules: checking eligibility, pulling clinical documentation, submitting standard requests, tracking status, and logging denials. These tasks have consistent inputs and outputs — software handles them reliably.
The remaining 35% stays human. That's where your team earns its value: negotiating complex denials, handling edge cases where patient circumstances don't fit standard criteria, exercising clinical judgment calls, and managing frustrated providers or patients who need a real conversation. Exceptions, appeals, and relationship-sensitive situations require someone who can read context and adapt.
On compensation ($42K–$50K range): as routine volume shifts to automation, the remaining human work becomes more cognitively demanding — handling only the hard cases. That likely argues for reconsidering how this role is defined and compensated over time.
Practically: your 21-person sample suggests meaningful capacity reallocation opportunity, not elimination — your team focuses on what machines genuinely cannot do.
Based on 21 postings our engine analyzed · updated .