Prior Authorizations Specialist

Prior Authorization Specialist

Addison Group is hiring for our client, a specialty physician practice in North Richland Hills, seeking two Prior Authorization Specialists to join its growing team.

This role will focus on obtaining insurance authorizations, verifying coverage, and communicating directly with insurance carriers to ensure services are approved prior to treatment. This is a great opportunity for someone with prior authorization or insurance experience who enjoys working with payers and helping patients navigate the authorization process.

Key Responsibilities

• Obtain prior authorizations for medical services and procedures
• Contact insurance companies by phone to verify coverage and authorization requirements
• Submit and follow up on authorization requests through payer portals
• Verify patient insurance benefits and eligibility
• Gather necessary clinical and insurance information for authorization requests
• Follow up on pending authorizations and resolve outstanding requirements
• Document authorization status and payer communications accurately
• Communicate authorization updates with providers and internal staff
• Help identify and resolve insurance-related issues that could delay patient care
• Maintain productivity and accuracy standards as department processes continue to develop

Qualifications

• 1+ year of prior authorization or healthcare insurance experience required; 2+ years preferred
• Experience communicating directly with insurance companies
• Knowledge of insurance verification and authorization processes
• Comfortable navigating insurance payer portals
• Strong phone and customer service skills
• Excellent attention to detail and follow-through
• Ability to learn new processes and systems quickly
• Experience with eClinicalWorks (eCW) preferred

Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.