• Clinical Pharmacist - Prior

    CVS Health (Austin, TX)
    …Pharmacist with CVS Health. This position is for a Clinical Pharmacist working in the Prior Authorization team. - Collaborates with the technicians and prior ... within the designated service level agreements. - Evaluate and review all prior authorization requests and render coverage determinations based on clinical… more
    CVS Health (08/17/25)
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  • LVN Care Review Clinician, Prior

    Molina Healthcare (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 (08/15/25)
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  • Prior Authorization Pharmacy…

    Actalent (Dallas, 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 (08/19/25)
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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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  • Patient Authorization and Referral…

    Providence (Lubbock, TX)
    …2 years of Medical office experience dealing with scheduling, telephone calls, prior pre-certification/ pre- authorization , as well as using an electronic medical ... patients requiring pre-certifications, referrals, RQI numbers or any kind of authorization from an insurance company. Primary responsibilities include speaking with… more
    Providence (08/13/25)
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  • Sr Analyst, Scope Management - Healthcare

    Evolent (Austin, TX)
    …and informatics professionals who work with national health plans to ensure that prior authorization and financial coding stay accurate, compliant, and aligned ... Management plays a crucial role in supporting the comprehensive management of prior authorization and financial scope within Evolent Specialty Services.… more
    Evolent (07/18/25)
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  • Supervisor, Provider Services

    Evolent (Austin, TX)
    …team, ensuring the effective and efficient management of operations related to prior authorization services for healthcare companies. This role is essential ... + Implement and manage processes that enhance efficiency and effectiveness in handling prior authorization requests. + Analyze call metrics and other performance… more
    Evolent (07/22/25)
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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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