• Clinical Pharmacist - Prior

    CVS Health (Austin, TX)
    …and/or medically necessary indications and review clinical documentation in support of prior authorization reviews. The primary function of the clinical ... and/or medically necessary indications and review clinical documentation in support of prior authorization reviews. You will also provide internal pharmacist… more
    CVS Health (08/22/25)
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  • (Remote) Prior Authorization

    Actalent (Houston, TX)
    Prior Authorizations + Insurance Verifications Qualifications: + 2+ year of Prior Authorization pharmacy experience is Mandatory + Pharmacy Tech State ... Certification is Mandatory AND PTCB is Mandatory If you are Interested , Kindly give a call : ### Pay and Benefits The pay range for this position is $18.00 - $20.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification… more
    Actalent (08/25/25)
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  • Medical Authorization Splst

    Methodist Health System (Dallas, TX)
    …professional responsible for verification of medical coverage, along with notification, prior authorization , and/or pre-determination of healthcare benefits for ... 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 (06/21/25)
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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 ... as needed. What You Bring: + Proven experience with insurance verification or prior authorization for infusions. + Strong understanding of healthcare billing and… more
    TEKsystems (08/15/25)
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  • Care Review Clinician, Prior Auth (RN) Pega…

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

    US Tech Solutions (TX)
    **Job Title:** ** Prior Authorization Pharmacist** **Location:Remote** **Duration: 6+ months contract** **Job Description:** + Responsible for reviewing and ... completing criteria based on prior authorization as per policy and procedure. **Responsibilities:** + This individual must have excellent interpersonal skills. +… more
    US Tech Solutions (08/20/25)
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  • Director - Billing Operations - Front End (Hybrid)

    Caris Life Sciences (Irving, TX)
    …of experience in revenue cycle management with a focus on benefit verification, prior authorization , or pre-billing activities or with accessioning within a lab ... upfront portion of the billing process, including benefit investigations, prior authorizations, financial clearance, and payer-specific requirements. This leader… more
    Caris Life Sciences (08/18/25)
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  • Pharmacy Technician

    Molina Healthcare (Houston, TX)
    …family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and ... **KNOWLEDGE/SKILLS/ABILITIES** + Performs initial receipt and review of non-formulary or prior authorization requests against plan approved criteria. Requests… more
    Molina Healthcare (08/27/25)
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  • Clinical Pharmacy Technician Sr

    Prime Therapeutics (Austin, TX)
    …Pharmacy Technician Sr **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone ... staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization outcomes in pharmacy system. + Communicates selected… more
    Prime Therapeutics (07/17/25)
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  • Representative, Pharmacy

    Molina Healthcare (Austin, TX)
    …family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and ... NCQA guidelines, and CMS standards. + Provides coordination and processing of pharmacy prior authorization requests and/or appeals. + Explains Point of Sale… more
    Molina Healthcare (08/27/25)
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