Authorization Specialist - II

Authorization Specialist - II

Immediate need for a talented Authorization Specialist - II. This is a 06+ months contract opportunity with long-term potential and is located in Texas (Remote).

Job ID:26-25422 Pay Range: $17 - $19/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• Authorization Specialist II team members are responsible for receiving, reviewing, validating, and creating prior authorization requests for multiple Medicaid products.
• Daily responsibilities include researching member and provider information, ensuring requests contain required documentation, building authorizations, conducting provider outreach for missing information, routing requests appropriately, documenting actions, and managing worklist inventory to meet turnaround time requirements.
• The team also supports transition-of-care activities, provider education, and special initiatives related to authorization processing.
• Success in the role is measured through productivity, quality, and turnaround time compliance.
• Specialists are expected to maintain daily production goals, accurately build authorizations, follow regulatory and business requirements, minimize processing errors, and manage inventory to prevent overdue requests.
• Team members are also expected to contribute to department goals related to volume management, quality audits, and service excellence.
• This role serves as the front end of the utilization management process and has a direct impact on timely member access to care.
• Specialists work with a wide variety of authorization types, provider groups, and Medicaid programs while collaborating closely with clinical reviewers, provider relations, and operations leadership.
• The position offers continuous learning opportunities through evolving healthcare regulations, system enhancements, workflow improvements, and cross-functional partnerships.
• Work Schedule: M-F 8:00am to 5:00pm CST (Possibility for weekend shift in the future but will be communicated to resource)

Key Requirements and Technology Experience:

• Primary Skills: Authorization, Prior-Authorization, Provider outreach, Claims, EHR/EMR, Medicaid/Managed care
• Top 3 must haves:
• Computer database
• Microsoft Suite; Excel, Word, Teams, Outlook
• Written/Verbal Communication Skills
• Required Education: Highschool Diploma/GED.
• Years of experience required: 1-2 years prior authorization experience.
• Provider outreach, healthcare insurance verification, ICD-10 Codes, CPT Codes knowledge.
• Since the client has requested for computer literacy and typing test, kindly take the two assessments with the links below:
• Computer Literacy:
• Typing Test (40 wpm):

Our client is a leading Pharmaceutical Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration. Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.