Average salary: $115,335 /yearly
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- ...and benefits for scheduled procedures and services. This role ensures accuracy in patient records and assists in obtaining prior authorizations, if needed, to facilitate timely reimbursement. The Insurance Verification Representative works closely with clinical and administrative...Suggested
Community Health Systems
Longview, TX18 hours ago - ...Researches patient information to assist care providers with medication refills. Corresponds with insurance companies regarding prior authorizations for medications. Communicates with relevant personnel regarding medication distribution, keeping all patient information...SuggestedWork at officeLocal areaImmediate start
Baylor University Medical Center
Dallas, TX2 days ago $18 - $23 per hour
...seeking a Medical Insurance Benefits Specialist in Plano, TX. This role involves performing benefit investigations, obtaining prior authorizations, and ensuring timely processing of patient prescriptions while demonstrating exceptional customer service. Candidates should...SuggestedHourly payWork at officeMonday to FridayCSI Pharmacy
Plano, TX18 hours ago- ...Authorization Support Specialist At CSI Pharmacy (CSI), we are on a mission to provide Specialty Pharmacy services to patients with chronic... ...Support Specialist plays a critical role in supporting the Prior Authorization (PA) workflow by ensuring timely follow-up,...SuggestedWork at officeMonday to Friday
CSI Pharmacy
Nash, TX4 days ago - ...Job Title The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required. Works directly with physician offices and payers to facilitate patient access to various therapies. Representative...Suggested
Hire Talent
Houston, TX1 day ago - ...Salary: DOE $/hr. on w2 only US Citizen and Green Card H4-EAD only No third party Strong PMs with clinical/pharma background. Need to be able to produce really good schedules Clinical skills: Claims processing Utilization Management Prior Authorizations......SuggestedContract workRemote work
Staffing the Universe
Houston, TX4 days ago - ...Duties include: Clinical utilization management oversight (authorizations, appeals, peer reviews, pharmacy, FWA) and clinical policy development... ...evaluation No call Need experience in managed care and prior authorization Active TX license, DEA, recent case logs...SuggestedHourly payPermanent employmentLocumImmediate startMonday to Friday
GO Staffing
Dallas, TX2 days ago $21.65 - $28.82 per hour
...adhering to departmental policies, state regulations, and quality assurance guidelines. Facilitate the processing of pharmacy prior authorization requests and appeals. Provide clear explanations of claims adjudication processes and relevant policies to various...SuggestedHourly payWork experience placementWork at officeShift workMolina Healthcare
Houston, TX3 days ago- ...and evolve a payer interoperability workspace that supports: Payer onboarding and integration readiness Electronic prior authorization (ePA) workflows Standards-based data exchange between payer and provider systems Tooling that enables operational scale...Suggested
athenahealth
Austin, TX1 day ago $21 - $23 per hour
...Rooming patients Collecting vitals Prepare and stock exam rooms Assisting with exams and procedures POC Prior Authorizations Front Office Operations Other duties as needed Schedule: Monday-Friday 8:30am-5:00pm Pay: $21-$23 per hour based...SuggestedHourly payTemporary workMonday to FridayActalent
Dallas, TX3 days ago- ...Associate Medical Director Job Details: • 13-week locum assignment with potential transition to permanent role • Reviews prior authorization and appeals requests based on medical necessity • Performs peer-to-peer calls to support utilization management processes...SuggestedHourly payWeekly payPermanent employmentLocumLocal area
BAS Healthcare
Dallas, TX1 day ago - ...Intake Clerk The Intake Clerk is responsible for obtaining prior authorizations for all Admissions within 24 Monday through Friday. Supports therapeutic setting. Essential Duties: Responsible for assisting with all admission process Responsible for assisting...SuggestedMonday to Friday
$17 per hour
...liliStay up to date on CPT, ICD, and LCD guidelines/liliChart and coding review/liliCheck eligibility and benefits/liliObtain prior authorizations/liliCall patients when necessary to verify insurance information/liliProvide excellent customer service to patients paying...SuggestedHourly payFull timeWork at officeShift work- ...locum assignment with the hope that the provider will transition into a permanent role. Responsibilities: ~ Reviews prior authorization and appeals request for approval or denial of claims payment based on medical necessity. ~ Performs peer to peer...SuggestedPermanent employmentLocumLocal areaRemote workWeekend work
Med Ninjas
Dallas, TX3 days ago - ...coordination Team Environment: Collaborative, mission-driven, community-centered Key Responsibilities Review prior authorizations, appeals, and medical necessity determinations Conduct peer-to-peer provider consultations Provide clinical...SuggestedFull timeLocumVisa sponsorshipFlexible hours
LanceSoft
Dallas, TX3 days ago $18 - $20 per hour
...accurately. You will play a crucial role in obtaining necessary authorizations and clinical information from prescribers, approving requests... ...in pharmacy operations and data entry. Experience with prior authorization processes. Knowledge of retail pharmacy operations...Contract workTemporary workRemote workActalent
Houston, TX4 days ago$140 per hour
...Fully remote (locums), hybrid upon permanent transition Pay Rate: $140/hour On Call / Weekends: None Key Responsibilities Review prior authorization and appeals requests for medical necessity determinations Conduct peer-to-peer reviews to support utilization management...Weekly payPermanent employmentLocumLocal areaImmediate startRemote workMonday to FridayWeekend workLanceSoft
Highland Park, TX3 days ago$47.4k - $64.34k
...UM Pharmacy Technician The UM Pharmacy Technician is responsible for the intake and review of prior authorization requests for medications requested under the medical benefit. The UM Pharmacy Technician makes approval decisions and denial recommendations based on predetermined...Temporary workWork experience placementLocal areaHealth First
Arlington, TX4 days ago- ...remote during the locum phase and transitions to a hybrid schedule upon permanent placement. Key Responsibilities Review prior authorization & appeals requests Conduct peer-to-peer consultations Provide oversight for utilization, quality & disease management programs...Permanent employmentLocumRemote workMonday to FridayWeekend work
LanceSoft
Dallas, TX18 hours ago - ...-coming calls from members, providers, etc providing professional phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of all approvals and denials, and transfers all clinical questions...
SAN ANTONIO STAFFING
San Antonio, TX1 day ago $174.07k - $374.92k
...precertification, concurrent review, and appeal request. This position is primarily responsible for Utilization Management, including prior authorization and precertification as well as concurrent review. Cases could focus on inpatient or outpatient, acute and post-acute as well...Hourly payFull timeTemporary workLocal areaWork from homeFlexible hoursWeekend workCVS Health
Mountain Home, TX2 hours agonew$118.45k - $260.59k
...(UM/CM), provider portals, or member engagement solutions + Familiarity with FHIR APIs, EDI transactions (834/835/837), and prior authorization workflows + Exposure to accessibility standards (WCAG) and health equity initiatives + Agile certification (CSPO, SAFe) or PMP...Hourly payFull timeTemporary workWork experience placementLocal areaFlexible hoursDallas Staffing
Dallas, TX18 hours ago- ...may include communicating with insurance providers, completing enrollment forms, reviewing benefit verifications, submitting prior authorizations, writing appeals or letters of medical necessity, and coordinating all efforts of specialty pharmacies and manufacturer HUBs...Temporary workWork at office
Epiphany Business Services, LLC
Fort Worth, TX18 hours ago $18 - $20 per hour
...phlebotomy required) Scheduling and rescheduling patient appointments Making and receiving patient phone calls Handling prior authorizations Supporting both clinical and front-office workflows as needed Must-Have Qualifications: Minimum 2+ years of...Contract workMonday to FridayMedix
Houston, TX3 days ago$30 - $40 per hour
...Triage patient symptoms and manage clinical phone lines Communicate lab and diagnostic results Complete medication prior authorizations and update EHR documentation Support scheduling, workflow, and compliance Educate patients and families on treatment plans...Contract workTemporary workActalent
Dallas, TX4 days ago- ...by Provider Run outstanding order reports for clinic follow-up Prepare medication refills for the Provider Obtain prior authorizations for medications when requested Assist in maintaining the medical inventory and placing orders for new materials as needed...Full timeTemporary workAfternoon shift
Pain Specialist of America LLC
Woodway, TX1 day ago - ...dermatologist. Ability for Clinical Research if interested Staff assist with all patient call backs, results, and prior authorizations. Duties and Essential Job Functions: Coordinates the multidisciplinary care delivered to all patients, to optimize...Full timeLocal areaRelocation package
JPS Health Network
Fort Worth, TX1 day ago - ...refill requests in a timely manner, checking faxes and responding to patient/pharmacy medication inquiries. Submit medication prior authorization in a timely and efficient manner, ensuring proper documentation in each patient record. Review and respond to all...Work at officeShift work
Discovery Behavioral Health
Austin, TX2 days ago $75k - $165k
...regulations and rating manual rules Developing and maintaining agency and broker relationships Working within broad limits and authorities on highly complex assignments This role will be filled at either the Underwriting Specialist OR Executive Underwriter level....Full timeContract workTemporary workApprenticeshipWork at officeLocal areaRemote workVisa sponsorshipZurich Insurance Company Ltd.
Texas18 hours ago$98.5k - $215k
...utilizing The Zurich Way of Underwriting Framework within delegated authority levels on a variety of accounts. We focus strongly on our... ...process, managing a qualified list of opportunities 90 to 120 days prior to effective date. Developing strong broker and client...Full timeApprenticeshipLocal areaRemote workVisa sponsorshipFlexible hoursZurich Insurance Company Ltd.
Dallas, TX18 hours ago
