Texas Licensed Authorization Specialist

Job Summary

A company is looking for an Authorization Specialist III to support the prior authorization request process in a remote setting.

Key Responsibilities

• Track and maintain authorization requests in accordance with insurance prior authorization guidelines
• Verify member insurance coverage and service eligibility to ensure timely payment adjudication
• Act as a subject matter expert on the authorization process and maintain relationships with service providers and clinical reviewers

Required Qualifications

• High School diploma or GED required
• 2 - 4 years of related experience preferred
• LVN license or similar experience preferred
• Strong knowledge of medical terminology and insurance
• Familiarity with healthcare authorization processes and policies