• Medical Authorization Specialist

    Methodist Health System (Richardson, TX)
    …responsible for verification of medical coverage, along with notification, prior authorization , and/or pre-determination of healthcare benefits for proposed ... initiate pre- authorization and resolve issues that arise during the prior authorizations process. Supports and promotes the vision, mission, and strategic plans… more
    Methodist Health System (07/19/25)
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  • Prior Authorization And Referral…

    University of Texas Rio Grande Valley (Edinburg, TX)
    …None Licenses/Certifications None Required Experience One (1) year of experience processing prior authorizations and referrals in a medical setting. Knowledge of ... Position Information Posting NumberSRGV8412 Working TitlePRIOR AUTHORIZATION AND REFERRAL SPECIALIST Number of Vacancies1 LocationEdinburg, Texas DepartmentSchool of… more
    University of Texas Rio Grande Valley (07/23/25)
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  • Prior Authorization Pharmacy…

    Actalent (Houston, TX)
    Prior Authorizations + Insurance Verifications Qualifications: + 2+ year of Prior Authorization pharmacy experience is Mandatory + Pharmacy Tech State ... the benefits available for this temporary role may include the following: * Medical , dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement… more
    Actalent (08/10/25)
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  • Senior Insurance Authorization Specialist…

    Houston Methodist (Houston, TX)
    …parties as needed. **SERVICE ESSENTIAL FUNCTIONS** + Initiate and manage the authorization process for medical services and simple procedures and treatments. ... FUNCTIONS** + Utilizes multiple online resources to initiate and verify proper insurance authorization is obtained timely and accurately prior to the patient's… more
    Houston Methodist (08/08/25)
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  • Care Review Clinician, Prior Auth (RN) Pega…

    Molina Healthcare (Houston, TX)
    …and its members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests ... benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina… more
    Molina Healthcare (07/12/25)
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  • Insurance Authorization Specialist- *Must…

    TEKsystems (Austin, TX)
    *Candidates must have prior experience with insurance verification or prior authorization for infusion therapies.* About the Role: + We are seeking a ... You Bring: + Proven experience with insurance verification or prior authorization for infusions. + Strong understanding...for this temporary role may include the following: * Medical , dental & vision * Critical Illness, Accident, and… more
    TEKsystems (07/30/25)
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  • Lead Utilization Management Coordinator- Fulltime

    Houston Behavioral Healthcare Hospital (Houston, TX)
    …Bachelors Degree in Psychology or related field preferred. 1 year experience in a medical related field and/or prior authorization experience preferred. 3 ... provided to patients or on behalf of patients in medical record and AIS. + Performs required task/duties accurately...care. + Assist with chart audits and completion of medical records. + Other duties as assigned Knowledge, Skills… more
    Houston Behavioral Healthcare Hospital (08/09/25)
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  • Client Services Specialist II

    US Tech Solutions (San Antonio, TX)
    …that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical pharmacist will apply ... Handles inbound phone calls and escalations from physicians or patients regarding Prior Authorization (50%) 4. Establishes and maintains communication, health… more
    US Tech Solutions (07/18/25)
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  • Care Review Clinician, PA (RN)

    Molina Healthcare (San Antonio, TX)
    …and its members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests ... a compact licensure. The ideal candidate will have experience with UM and prior authorization , within both Physical Health and Behavioral Health. Candidates with… more
    Molina Healthcare (08/08/25)
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  • Care Review Clinician, PA (RN) Transplants

    Molina Healthcare (Fort Worth, TX)
    …and its members. + Processes requests within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests ... benefits and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina… more
    Molina Healthcare (07/17/25)
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