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Insurance Prior Authorization Jobs in Houston, TX

Onco360

Pharmacy Prior Authorization Specialist

Houston, TX · On-site

$19.50 - $25.25/hr

Company Paid Life Insurance; and Short/Long-Term Disability What You'll Do The Pharmacy Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations ...

Onco360

Pharmacy Prior Authorization Specialist

Houston, TX · On-site +1

$19.50 - $25.25/hr

Company Paid Life Insurance; and Short/Long-Term Disability What You'll Do The Pharmacy Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations ...

Allmed Staffing Inc

Pharmacy Technician

Houston, TX · Remote

$20/hr

Submit prior authorization cases and required information to insurance payers. * Follow up with payers regarding pending prior authorization cases. * Communicate with pharmacies regarding medication ...

Allmed Staffing Inc

Pharmacy Technician

Houston, TX · Remote

$20/hr

Submit prior authorization cases and required information to insurance payers. * Follow up with payers regarding pending prior authorization cases. * Communicate with pharmacies regarding medication ...

Allmed Staffing Inc

Pharmacy Technician

Houston, TX · Remote

$20/hr

Submit prior authorization cases and required information to insurance payers. * Follow up with payers regarding pending prior authorization cases. * Communicate with pharmacies regarding medication ...

PARADIGM HEALTHCARE

Nurse Case Manager

Houston, TX · On-site

$70 - $95/hr

... Prior Authorization Liaison-Managed Care Department is responsible for providing comprehensive telephonic case management, insurance verification, and authorization services for our skilled nursing ...

New

ConnectMed360

Oncology Case Manager

Houston, TX · On-site +1

$60K/yr

Working knowledge and experience with health insurance (pharmacy benefit), Medicare Part D coverage, prior authorization processes, and medication reimbursement specifically for specialty drugs

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All JobsInsurance Prior Authorization JobsInsurance Prior Authorization Jobs in Houston, TX

Insurance Prior Authorization information

See Houston, TX salary details

$24.4K

$62.7K

$79.7K

How much do insurance prior authorization jobs pay per year?

As of Sep 5, 2026, the average yearly pay for insurance prior authorization in Houston, TX is $62,695.00, according to ZipRecruiter salary data. Most workers in this role earn between $58,300.00 and $73,500.00 per year, depending on experience, location, and employer.

What is insurance prior authorization?

Insurance prior authorization is a process where healthcare providers must obtain approval from a patient's insurance company before performing certain medical procedures, prescribing medications, or providing specific services. This ensures that the recommended treatment is covered under the patient's insurance plan and is deemed medically necessary. The process may involve submitting clinical information and waiting for a decision from the insurance provider. Prior authorization is intended to control costs and ensure appropriate care, but it can sometimes delay access to treatment.

What are the key skills and qualifications needed to thrive in insurance prior authorization?

To thrive in Insurance Prior Authorization, you need a solid understanding of medical terminology, insurance policies, and healthcare regulations, often supported by experience in a healthcare or insurance setting. Familiarity with electronic health record (EHR) systems, insurance portals, and authorization management software is typically required. Attention to detail, strong organizational skills, and effective communication are critical soft skills for managing complex cases and coordinating with providers and payers. These competencies ensure timely approvals, reduce claim denials, and improve patient access to necessary medical treatments.

What are some common challenges faced in an insurance prior authorization role, and how can they be effectively managed?

One of the main challenges in Insurance Prior Authorization is navigating the varying requirements and documentation standards of different insurance providers. This often requires staying updated on policy changes and maintaining close attention to detail to prevent delays or denials. Effective communication with healthcare providers and insurance representatives is also essential, as misunderstandings or incomplete information can slow down the process. Building strong organizational skills and using robust tracking systems can help manage workloads and ensure timely approvals, ultimately supporting patient care.

What is the difference between Insurance Prior Authorization vs Insurance Claims Specialist?

AspectInsurance Prior AuthorizationInsurance Claims Specialist
Required CredentialsKnowledge of insurance policies, healthcare regulationsUnderstanding of claims processing, coding, documentation
Work EnvironmentHealthcare providers, insurance companies, hospitalsInsurance companies, healthcare organizations, billing departments
Employer & Industry UsageUsed to approve coverage before services are renderedHandles post-service claims, reimbursement processing
Search & Comparison IntentUnderstanding pre-authorization processClaims processing and reimbursement procedures

Insurance Prior Authorization involves obtaining approval from insurance companies before healthcare services are provided, ensuring coverage. In contrast, Insurance Claims Specialists process claims after services are rendered to secure payment. Both roles require knowledge of insurance policies but focus on different stages of the insurance process.

Are insurance prior authorization jobs in high demand?

Insurance prior authorization jobs are in steady demand due to the ongoing need for healthcare cost management and insurance processing. These roles often require strong organizational skills and familiarity with insurance policies and medical billing systems, making them a stable career option in the healthcare administration field.

How to become an insurance prior authorization specialist?

To become an insurance prior authorization specialist, candidates typically need a high school diploma or equivalent, along with experience in healthcare or insurance billing. Relevant skills include knowledge of insurance policies, medical terminology, and proficiency with electronic health record (EHR) systems; certifications such as the Certified Professional Coder (CPC) can enhance job prospects.

Is insurance prior authorization a stressful job?

Insurance prior authorization is often considered a stressful job due to the need for accuracy, attention to detail, and managing multiple cases under tight deadlines. Employees frequently handle complex documentation and communicate with healthcare providers and insurance companies, which can contribute to work-related stress. Strong organizational skills and familiarity with insurance policies can help mitigate some of these challenges.

What are the most commonly searched types of Insurance Prior Authorization jobs in Houston, TX?

The most popular types of Insurance Prior Authorization jobs in Houston, TX are:

What cities near Houston, TX are hiring for Insurance Prior Authorization jobs?

Cities near Houston, TX with the most Insurance Prior Authorization job openings:

Insurance Prior Authorization jobs near you
Infographic showing various Insurance Prior Authorization job openings in Houston, TX as of August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 20% Part Time, and 5% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $62,695 per year, or $30.1 per hour.

Prior Authorization Specialist (3176)

HeartPlace, PLLC

Houston, TX • On-site

$15 - $20.25/hr

Full-time

Posted 14 days ago

Job description

US Heart and Vascular is in need of a Cardiology Prior Authorizations Specialist to join our team at Willowbrook Cardiovascular Associates in Houston, TX.
If you have a passion for obtaining prior authorizations for Veins, Structural Heart and CT Studies, please join our US Heart and Vascular team
Responsibilities:
• Ensures timely and accurate insurance authorizations are in place prior to services being rendered.• Verifies insurance eligibility and benefit levels to ensure adequate coverage for identified services prior to receipt.• Responsible for verification and investigation of pre-certification, authorization, and referral requirements for services.• Coordinates and supplies information to the review organization (payer) including medical record information and/or letter of medical necessity for determination of benefits.• Collaborates with designated clinical contacts regarding encounters that require escalation to peer-to-peer review.• Communicates with patients, clinical partners, financial counselors, and others as necessary to facilitate the authorization process.• Appropriately prioritizes workload to ensure the most urgent cases are handled in a timely manner.• Completes accurate documentation in all applications.• Follows departmental policies and procedures, when necessary, authorization is not obtained before the service date.• Answers provider, staff, and patient questions surrounding insurance authorization requirements.• Handles escalated authorization requests as needed.• Provides team mentorship as needed.• Works other departmental tasks as needed.
Requirements:
• Familiarity with medical office procedures and billing practices• Proficient in clinical documentation review for alignment with insurance authorization requirements• Responsible for compliance with all regulatory requirements and/or guidelines. These requirements/guidelines include, but are not limited to: OSHA, HIPAA, Federal Fraud and Abuse laws.• High School Diploma or equivalent required• Associate's degree in healthcare administration or business administration preferred• A minimum of 3-5 years' experience in the same role, or related field in a healthcare setting is required.• ECW experience is preferred.
Why Choose Us?
  • Comprehensive benefits package
  • Monday-Friday schedule

About Houston, TX:
Houston is a diverse city with a booming job market in energy, healthcare, and tech. It has no state income tax, an affordable cost of living, and world-class dining and entertainment. Green spaces, museums, and pro sports teams add to its appeal. Whether for career growth or culture, Houston has it all.

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