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Insurance Prior Authorization Jobs in Houston, TX

HeartPlace, PLLC

Prior Authorization Specialist (3176)

Houston, TX · On-site

$15 - $20.25/hr

... 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. • ...

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 ...

Actalent

Certified Pharmacy Technician

Texas City, TX · On-site

$15.50 - $18.75/hr

100% Remote Pharmacy Technician - Prior Authorization Review This remote Pharmacy Technician role focuses on reviewing pharmacy prior authorization requests for a large health insurance pharmacy ...

Actalent

Certified Pharmacy Technician

Santa Fe, TX · On-site

$16.75 - $20.25/hr

100% Remote Pharmacy Technician - Prior Authorization Review This remote Pharmacy Technician role focuses on reviewing pharmacy prior authorization requests for a large health insurance pharmacy ...

New

Aston Carter

Client Support Representative

Houston, TX · On-site

$20/hr

Conduct insurance verification by confirming eligibility, benefits, and coverage details with insurance agents. * Gather and document prior authorization information and perform related follow-up ...

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

Connect Med 360

Oncology Case Manager

Houston, TX · On-site

$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

Mehta Medical Group PLLC

Surgical Scheduler

Humble, TX · On-site

$18 - $22/hr

Insurance Verification & Authorizations * Verify insurance eligibility and benefits. * Obtain prior authorizations for surgical procedures. * Ensure all authorization requirements are completed ...

New

IQVIA

Care Manager

Houston, TX · Remote

Care Managers are responsible for contacting insurance companies to obtain correct eligibility information, perform benefit investigations, copay assistance and check prior authorization and/ or ...

New

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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 Aug 27, 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.

Customer Service / Prior Authorization Representative

Houston, TX

Gryphon Healthcare
Health Care and Social Assistance • 51 - 200 employees
Learn more about Gryphon Healthcareexternal

$15.25 - $20.75/hr

Full-time

Medical

Re-posted 5 days ago

Job description

Customer Service / Prior Authorization Representative
We are seeking an enthusiastic and detail-oriented Customer Service / Prior Authorization Representative to join our team. In this role, you will serve as the first point of contact for our patients while also managing prior authorization requests to help ensure timely access to care.
The ideal candidate will have prior authorization experience in a medical setting, with Radiology experience strongly preferred. You will work closely with our client medical offices, insurance carriers, and internal teams to obtain authorizations, verify benefits, resolve patient inquiries, and support the Medical Records Department.
The Ideal Candidate Will Have:
  • Previous prior authorization experience is required – Minimal 1 year experience required
  • Radiology prior authorization experience is strongly preferred
  • Experience with medical insurance verification
  • Knowledge of commercial insurance plans, Medicare, and Medicaid
  • Ability to interpret Explanation of Benefits (EOBs)
  • Strong attention to detail and accurate data entry skills
  • Excellent communication and customer service skills
  • Previous call center or high-volume patient service experience
  • A passion for helping patients and providing exceptional customer service
If you thrive in a fast-paced healthcare environment and enjoy helping patients while ensuring timely authorization of medical services, we encourage you to apply!
Job Description – Customer Service / Prior Authorization Representative
Location: Houston, TX 77041
Job Summary
The Customer Service / Prior Authorization Representative is responsible for responding to patient account inquiries, obtaining and managing insurance prior authorizations, verifying insurance eligibility and benefits, processing patient payments, generating patient statements, and assisting with medical records requests. This position works closely with providers, insurance companies, and patients to ensure services are authorized and patient billing questions are resolved accurately and efficiently.
Duties and Responsibilities
  • Answer incoming calls from patients and customers, identifying the type of assistance needed.
  • Obtain, submit, monitor, and document insurance prior authorizations for medical services and procedures.
  • Verify insurance eligibility, benefits, authorization requirements, and referral requirements.
  • Follow up with insurance carriers regarding pending or denied authorizations and appeals as appropriate.
  • Coordinate with physician offices, scheduling staff, and clinical personnel to obtain required documentation for authorization requests.
  • Ask appropriate questions and actively listen to identify customer concerns while accurately documenting information in company systems.
  • Research patient accounts and healthcare claims using multiple computer systems.
  • Ensure appropriate insurance benefits are applied to each patient account.
  • Resolve patient billing questions using clear, professional communication.
  • Process patient payments and generate patient statements.
  • Assist the Medical Records Department by retrieving records for patients, attorneys, and third-party vendors.
  • Meet established performance goals for quality, productivity, customer satisfaction, accuracy, and attendance.
  • Demonstrate excellence in customer service with every patient interaction.
  • Participate in continuing education to remain current on medical billing, insurance regulations, and prior authorization requirements.
  • Support other members of the Revenue Cycle team as needed.
  • Perform other duties as assigned.
Competencies
  • Customer Service
  • Problem Solving
  • Analytical Thinking
  • Attention to Detail
  • Technical Skills
  • Oral Communication
  • Written Communication
  • Teamwork
  • Organization and Time Management
  • Ethics and Confidentiality
  • Adaptability
Education Requirements
  • High School Diploma or equivalent required.
Experience Requirements
  • Minimum of one (1) year of customer service experience in a medical office, clinic, hospital, emergency room, or healthcare setting.
  • Minimum of one (1) year of prior authorization experience required.
  • Radiology prior authorization experience strongly preferred.
  • Medical billing and insurance verification experience preferred.
Special Knowledge, Skills, and Abilities Required
  • Knowledge of insurance prior authorization processes and payer requirements.
  • Knowledge of commercial insurance, Medicare, Medicaid, and managed care plans.
  • Knowledge of medical billing and collection practices.
  • Ability to interpret Explanation of Benefits (EOBs).
  • Familiarity with EMR/EHR systems, EDI, and insurance portals.
  • Understanding of HIPAA regulations and patient confidentiality requirements.
  • Strong organizational, follow-up, and time management skills.
  • Excellent verbal and written communication skills.
  • Ability to multitask and prioritize in a fast-paced environment.
  • Detail-oriented with accurate data entry skills.
  • Proficiency with Microsoft Outlook and Windows-based computer systems.
  • Bilingual (English/Spanish) is a plus but not required.
Working Environment
Ability to work in a fast-paced, high-volume healthcare environment. Must be able to manage multiple priorities while maintaining accuracy and excellent customer service. Flexibility to work additional hours as needed to meet business demands.

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