Prior Authorization Specialist

Prior Authorization & Insurance Support Specialist



Location: Plano, TX



Schedule: M-F 8:30am-5pm



Pay Range: $21.00 - $28.00/hour (Based on Experience)



Position Type: Full-Time, Contract-to-Hire


Are you a healthcare investigator?


We are looking for an Authorization Support Specialist who thrives on the "investigation"-someone who isn't afraid to pick up the phone, dig into medical policies, and solve the puzzles that stand between a patient and their therapy.


If you are "hungry" to make a real impact and want a role where you can truly own the process from start to finish, this is your career spot.


The Mission


You will be the frontline advocate for our patients, managing the end-to-end Prior Authorization (PA) workflow. This isn't just portal data entry; it's a high-touch, critical role requiring deep dives into medical necessity and persistent follow-up with insurance payers.


What You'll Do

• Work the Problem: Proactively contact insurance companies via phone and portals to obtain real-time status updates. If a PA is stuck, you find out why.
• The Deep Dive: Review medical policies and denial letters for clinical clarity. You'll ensure all documentation is "bulletproof" before it hits the Clinical Utilization Team.
• Data Integrity: Accurately track authorization numbers, effective dates, and approval letters in CareTend , ensuring zero delays in patient therapy.
• Collaborate: Act as a bridge between Pharmacy Operations, Intake, and the Revenue Cycle teams to provide seamless patient care.
• Audit & Audit Again: Conduct patient chart audits and maintain meticulous records in accordance with compliance and department guidelines.

What You Bring to the Table

• Experience: 1-2+ years in healthcare administrative support, pharmacy billing, or insurance verification. Experience with Specialty Pharmacy or Home Infusion is a major plus.
• The Investigative Mindset: You don't just pass the buck. You want to understand the "inner workings" of a denial and stay on the line until you have an answer.
• Technical Savvy: You are comfortable navigating complex software and insurance portals. (Prior experience with CareTend is a plus)
• Patient-First Heart: You understand that behind every authorization is a person going through a hard medical journey. You are motivated by their success.
• Licensure: A Texas Pharmacy Technician License or PTCB/NHA certification is not required, but we value the expertise if you have it!

Perks

• Competitive Pay: A wide range ($21-$28) to reward high-level expertise and potential.
• Growth Opportunity: We are rapidly expanding. For the right person, this is a long-term career path, not just a job.
• Meaningful Work: Every approval you secure directly changes a patient's life.

Ready to roll up your sleeves? Submit your application today. We are looking for candidates who can demonstrate their persistence and technical knowledge during our interview process.


* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).


* As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients