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Home Based Prior Authorization Jobs in Texas (NOW HIRING)

SGS Consulting

Tech I - Prior Authorization

Richardson, TX · On-site

$16 - $19.25/hr

... based upon established standards. * Comply with departmental, company, state, and federal ... Prior Authorization requires a cpht for the role along with a High School Diploma or GED.

SGS Consulting

Tech I - Prior Authorization

Richardson, TX · On-site

$16 - $19.25/hr

... based upon established standards. * Comply with departmental, company, state, and federal ... Prior Authorization requires a cpht for the role along with a High School Diploma or GED.

Medix

Onsite Prior Authorization Specialist

Plano, TX · On-site

$23 - $26/hr

Prior Authorization Status Follow-Up: Proactively contact insurance companies via phone, portals ... Ability to manage a high volume of pending authorizations and prioritize follow-ups based on ...

W3R

Prior Authorization Therapist

Austin, TX · On-site

These relationships are based on mutual interest, and create added value for all parties involved ... home, at work and in the community to ensure medically appropriate, high quality, cost effective ...

W3R

PRIOR AUTHORIZATION THERAPIST

Austin, TX

These relationships are based on mutual interest, and create added value for all parties involved ... home, at work and in the community to ensure medically appropriate, high quality, cost effective ...

W3R

Prior Authorization Therapist

Austin, TX · On-site

These relationships are based on mutual interest, and create added value for all parties involved ... home, at work and in the community to ensure medically appropriate, high quality, cost effective ...

Medix

Prior Authorization Pharmacy Technician

Plano, TX · On-site

$23 - $26/hr

Prior Authorization Submission & Processing: Prepare and submit prior authorization requests ... Eligibility for health benefits is based on verifying that an average of 30 hours per week during ...

W3R

RN Prior Authorization

Austin, TX

These relationships are based on mutual interest, and create added value for all parties involved ... Private Duty, Home Health, Pediatrics, Children Special Healthcare Needs (CSHCN), Chronic Care ...

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Home Based Prior Authorization information

What is a home based prior authorization specialist?

A Home Based Prior Authorization specialist is a healthcare professional who works remotely to review and process prior authorization requests for medical procedures, medications, or services. Their main role is to ensure that treatments and prescriptions meet insurance requirements before approval, helping patients receive necessary care while managing costs for providers and insurers. These specialists communicate with healthcare providers, insurance companies, and sometimes patients, using secure online systems to perform their duties from home. Their work is critical in streamlining healthcare access and preventing unnecessary delays in treatment.

What are the key skills and qualifications needed to thrive as a home based prior authorization specialist?

To thrive as a Home Based Prior Authorization Specialist, you need a solid understanding of medical terminology, insurance policies, and healthcare procedures, often supported by experience in medical billing or coding. Familiarity with electronic health record (EHR) systems, payer portals, and prior authorization software is typically required, along with certifications like CPC or CPB being advantageous. Strong attention to detail, effective communication, and the ability to work independently are valuable soft skills in this remote role. These competencies ensure timely and accurate authorization processing, reduce claim denials, and support seamless patient care coordination.

What are some common challenges faced in a home based prior authorization role and how can they be managed?

One common challenge in a home-based prior authorization role is maintaining effective communication with healthcare providers and insurance companies while working remotely. This can be managed by utilizing secure digital communication tools and staying organized with thorough documentation. Another challenge is staying updated on frequently changing insurance policies and regulations, which can be addressed by participating in ongoing training and regularly reviewing updates from payers. Additionally, managing distractions and maintaining productivity at home requires setting a dedicated workspace and a structured daily routine.

What is the difference between Home Based Prior Authorization vs Medical Coder?

AspectHome Based Prior AuthorizationMedical Coder
CredentialsTypically requires healthcare experience, knowledge of insurance policies, and sometimes certifications in healthcare administrationRequires coding certifications like CPC, CCS, or CCS-P
Work EnvironmentRemote, healthcare or insurance company settingRemote or on-site, healthcare facility or billing office
Industry UsageUsed in insurance, healthcare administration, and utilization reviewUsed in medical billing, coding, and health information management

Home Based Prior Authorization specialists focus on reviewing and approving insurance requests for medical procedures, requiring healthcare knowledge. Medical Coders translate medical records into codes for billing, requiring coding certifications. While both roles are remote and healthcare-related, they serve different functions within the healthcare industry.

What are the most commonly searched types of Prior Authorization jobs in Texas?

The most popular types of Prior Authorization jobs in Texas are:

What are popular job titles related to Home Based Prior Authorization jobs in Texas?

For Home Based Prior Authorization jobs in Texas, the most frequently searched job titles are:

What job categories do people searching Home Based Prior Authorization jobs in Texas look for?

The top searched job categories for Home Based Prior Authorization jobs in Texas are:

Home Based Prior Authorization jobs near you
Infographic showing various Home Based Prior Authorization job openings in Texas as of June 2026, with employment types broken down into 1% As Needed, 88% Full Time, 2% Part Time, 8% Contract, and 1% Nights. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution.

Tech I - Prior Authorization

Richardson, TX • On-site

SGS Consulting
Recruiting and Staffing Services • 1 - 5K employees
Learn more about SGS Consultingexternal

$16 - $19.25/hr

Contractor

Re-posted 29 days ago

Job description

Company Description


Job Description

Job Responsibilities:

  • The Tech I will also assist with other duties such as outbound calls, monitoring / responding to inquiries in mailboxes and other duties as assigned by the leadership team.
  • Effectively manage work volume by handling inbound calls / fax requests utilizing appropriate courteous and professional behaviour based upon established standards.
  • Comply with departmental, company, state, and federal requirements when processing all information to ensure accuracy of information being provided to internal and external customers.
  • This position takes in-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 and judgment calls to the pharmacist.

 

Duties:

  • Analyse clinical algorithms and provide decisions regarding PA Requests.
  • Use of online databases and other resources to document appropriate recommendations, clinical decisions and responses.
  • Provide ongoing education on the PA Program to healthcare providers and internal partners.
  • Deliver the highest quality customer service to healthcare providers and internal providers in a high paced dedicated PA program.
  • Ability to deal with a diverse customer base in a friendly and confident manner (internal and external customers).
  • Excellent communication skills (oral, written, grammar, listening).
  • PC Windows experience required.
  • Ability to maintain confidentiality.

Shift Times:

  • 8.00 AM TO 4.30 PM

 

Training Information:

  • Training During Day from 9/29 - 10/10 (Monday - Friday)
  • Shift: 6:00AM - 2:30PM
Qualifications

 Experience / Education:

  • Minimum three years' experience required in a customer service position with high volume call centre experience
  • Preferably in healthcare, social services, or a similar service position.
  • Prior Authorization requires a cpht for the role along with a High School Diploma or GED.
Additional Information
All your information will be kept confidential according to EEO guidelines.

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