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Prior Auth Jobs in Texas (NOW HIRING)

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Prior Auth information

What is the difference between Prior Auth vs Medical Billing Specialist?

AspectPrior AuthMedical Billing Specialist
Required CredentialsKnowledge of insurance policies, certifications varyCertification often preferred, knowledge of billing codes
Work EnvironmentHealthcare offices, insurance companiesMedical offices, billing companies
Employer & Industry UsageUsed in healthcare to authorize proceduresUsed to process and submit medical claims
Common Search & ComparisonYesYes

Prior Auth involves obtaining approval from insurance companies before procedures, while Medical Billing Specialists handle the billing process after services are provided. Both roles are essential in healthcare administration but focus on different stages of patient care and reimbursement.

Are prior authorization jobs in high demand?

Prior authorization jobs are in steady demand due to the increasing complexity of healthcare billing and insurance requirements. These roles often require knowledge of medical policies and the use of authorization software, making skilled professionals valuable in healthcare administration. The demand is expected to grow as healthcare providers seek to streamline approval processes and reduce claim denials.

How do I become a prior authorization specialist?

To become a prior authorization specialist, candidates typically need a high school diploma or equivalent, along with experience in healthcare or insurance. Relevant skills include knowledge of medical billing, coding, and insurance policies, and certifications such as Certified Medical Administrative Assistant (CMAA) or Certified Coding Associate (CCA) can enhance job prospects. On-the-job training is common, and strong communication and organizational skills are essential for success in this role.

Is prior authorization a stressful job?

Prior authorization jobs can be stressful due to the need for accuracy, attention to detail, and managing tight deadlines to secure approvals quickly. The role often involves handling complex insurance policies and communicating with healthcare providers, which can contribute to workload pressure. However, stress levels vary depending on the work environment and individual coping strategies.

What are popular job titles related to Prior Auth jobs in Texas?

For Prior Auth jobs in Texas, the most frequently searched job titles are:

What job categories do people searching Prior Auth jobs in Texas look for?

The top searched job categories for Prior Auth jobs in Texas are:

What cities in Texas are hiring for Prior Auth jobs?

Cities in Texas with the most Prior Auth job openings:

Infographic showing various Prior Auth job openings in Texas as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 15% Part Time, 1% Temporary, 3% Contract, and 1% Nights. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution.

Clearance Specialist - Benefit Verification - Specialty Infusion

Frisco, TX • On-site

Soleo Health Inc
Health Care and Social Assistance • 1 - 5K employees
Learn more about Soleo Health Incexternal

$23 - $27/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 8 days ago

Job description

Description:

Soleo Health is seeking a Clearance Specialist to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care!  


Specialty infusion experience and ability to work 8:30a-5pm central time zone required.

Soleo Health Perks:

  • Competitive Wages  
  • 401(k) with a Match 
  • Referral Bonus    
  • Paid Time Off 
  • Great Company Culture  
  • Annual Merit Based Increases 
  • No Weekends or Holidays   
  • Paid Parental Leave Options 
  • Affordable Medical, Dental, & Vision Insurance Plans 
  • Company Paid Disability & Basic Life Insurance 
  • HSA & FSA (including dependent care) Options 
  • Education Assistance Program   

This Position:

The Clearance Specialist is responsible for processing new referrals including but not limited to verifying patient eligibility, test claim adjudication, coordination of benefits, and identifying patient estimated out of pocket costs. They will also be responsible for preparation, submission, and follow up of payer authorization requests. Responsibilities include:

  • Perform benefit verification of all patient insurance plans including documenting coverage of medications, administration supplies, and related infusion services
  • Responsible to document all information related to coinsurance, copay, deductibles, authorization requirements, etc
  • Calculate estimated patient financial responsibility based off benefit verification and payer contracts and/or company self-pay pricing
  • Initiate, follow-up, and secure prior authorization, pre-determination, or medical review including reviewing and obtaining clinical documents for submission purposes
  • Communicate with patients, referral sources, other departments, and any other external and internal customers regarding status of referral, coverage and/or other updates as needed 
  • Refer or assist with enrollment any patients who express financial necessity to manufacturer copay assistance programs and/or foundations
  • Generate new patient start of care paperwork 
  • Other duties as assigned

Schedule:

  • Monday-Friday,  8:30a-5pm central time zone 
Requirements:
  • At least 2 years of home infusion specialty pharmacy intake experience required
  • High school diploma or equivalent
  • Working knowledge of Medicare, Medicaid, and managed care reimbursement guidelines including ability to interpret payor contract fee schedules based on NDC and HCPCS units 
  • Strong ability to multi-task and support numerous referrals/priorities while ensuring productivity expectations and quality are met
  • Ability to work in a fast-paced environment
  • Knowledge of HIPAA regulations
  • Basic level skill in Microsoft Excel & Word
  • Knowledge of CPR+ preferred

About Us: Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference! 


Soleo’s Core Values:

  • Improve patients’ lives every day
  • Be passionate in everything you do
  • Encourage unlimited ideas and creative thinking
  • Make decisions as if you own the company
  • Do the right thing
  • Have fun!

Soleo Health is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture.  

Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor.

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