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Prior Authorization Associate Jobs in Denton, TX

Care Options for Kids

Senior Authorization Specialist

Dallas, TX · On-site

$17.75 - $23.75/hr

The Senior Associate role serves as a subject matter expert and escalation point within the revenue ... Obtain prior authorizations and pre-certifications for in-home nursing services for a dedicated ...

New

MIND BODY OPTIMIZATION 1

Medication Coordinator

Fort Worth, TX · On-site

$16.25 - $21.50/hr

... associate degree or medical/administrative training preferred * Minimum 1-2 years of experience in a healthcare or medical office setting * Familiarity with prior authorization processes and ...

Naira S Babaian, MD, PA

Front Desk Associate - FT

Plano, TX · On-site

$13 - $16.75/hr

We are seeking to add a Front Desk Associate to our busy medical office in Plano, TX. This ... Verify insurance benefits and obtain prior authorizations * Collect co-pays and outstanding ...

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All JobsPrior Authorization Associate JobsPrior Authorization Associate Jobs in Denton, TX

Prior Authorization Associate information

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How much do prior authorization associate jobs pay per hour?

As of Aug 22, 2026, the average hourly pay for prior authorization associate in Denton, TX is $17.83, according to ZipRecruiter salary data. Most workers in this role earn between $14.18 and $18.94 per hour, depending on experience, location, and employer.

What is a prior authorization associate?

Prior Authorization Associates are professionals who handle the process of obtaining approval from insurance companies before certain medical services, procedures, or medications are provided to patients. They review clinical documentation, communicate with healthcare providers and insurers, and ensure all necessary information is submitted for timely authorization. Their work helps reduce claim denials and ensures patients receive the care they need while adhering to insurance requirements.

What are the key skills and qualifications needed to thrive as a prior authorization associate?

To thrive as a Prior Authorization Associate, you need a strong understanding of medical terminology, insurance processes, and prior authorization requirements, often backed by a high school diploma or associate degree. Familiarity with healthcare management software, electronic health record (EHR) systems, and payer portals is typically required. Excellent attention to detail, organizational skills, and effective communication are essential soft skills for this role. These skills ensure timely and accurate processing of prior authorizations, minimizing delays in patient care and supporting efficient healthcare operations.

What are some common challenges faced by a prior authorization associate, and how can they be effectively managed?

Prior Authorization Associates often encounter challenges such as navigating complex insurance requirements, handling high volumes of authorization requests, and managing tight turnaround times. Staying organized, keeping up-to-date with payer policies, and using robust tracking systems can help manage these difficulties. Collaborating closely with clinical staff and insurance representatives is also essential for resolving issues quickly and ensuring approvals are processed efficiently. Developing strong communication and problem-solving skills is key to success in this role.

What is the difference between Prior Authorization Associate vs Medical Billing Specialist?

AspectPrior Authorization AssociateMedical Billing Specialist
CredentialsHigh school diploma or equivalent; certification in medical billing or coding often preferredHigh school diploma or equivalent; certification in medical billing or coding often preferred
Work EnvironmentHealthcare offices, insurance companies, hospitalsHealthcare offices, billing companies, hospitals
Primary ResponsibilitiesObtain prior authorizations from insurance for procedures and treatmentsProcess and submit medical claims, handle billing and payments

The main difference is that a Prior Authorization Associate focuses on securing insurance approvals before procedures, while a Medical Billing Specialist manages the billing process after services are rendered. Both roles require similar credentials and often work in healthcare settings, but their core functions differ in the patient care and revenue cycle process.

Is a prior authorization associate a stressful job?

A prior authorization associate's job can be stressful due to the need for accuracy, meeting deadlines, and managing complex insurance requirements. The role often involves handling high volumes of requests and communicating with healthcare providers and insurers, which can contribute to workplace pressure.

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

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

What job categories do people searching Prior Authorization Associate jobs in Denton, TX look for?

The top searched job categories for Prior Authorization Associate jobs in Denton, TX are:

What cities near Denton, TX are hiring for Prior Authorization Associate jobs?

Cities near Denton, TX with the most Prior Authorization Associate job openings:

Prior Authorization Associate jobs near you

Prior Authorization Representative

US Neurology Associates

Frisco, TX

$35K - $40K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 16 days ago

Job description

PRIOR AUTHORIZATION REPRESENTATIVE

Texas Institute for Neurological Disorders / US Neurology Associates
Department: Revenue Cycle / Operations
Schedule: Full-Time, Monday–Friday
Location: On-Site, Plano / Frisco

 

The Prior Authorization Representative is responsible for completing high-volume, end-to-end prior authorization work for a multi-site outpatient neurology practice. This role supports office visits, diagnostic testing, procedures, infusion therapies, injections, and ancillary services by ensuring payer requirements are met before scheduled care.

The ideal candidate brings direct, dedicated prior authorization experience in neurology, infusion, or another complex specialty care setting. This is not an entry-level or adjacent front-desk, billing, or insurance verification role; the successful candidate must be able to independently manage authorization queues, payer portals, clinical documentation requirements, denials, and time-sensitive follow-up.

KEY RESPONSIBILITIES

Authorization Processing

  • Initiate, submit, track, and close prior authorization requests for office visits, MRI, EMG, EEG, sleep studies, infusions, Botox and other injections, and additional diagnostic and ancillary services.
  • Review scheduled services and payer requirements to determine authorization, referral, and medical necessity documentation needs.
  • Obtain and organize clinical records, diagnosis codes, procedure codes, treatment plans, and supporting documentation required for submission.
  • Complete authorization activity through payer portals, phone, fax, and electronic workflows within established turnaround times.
  • Monitor pending cases daily and proactively follow up with payers, providers, and clinical teams until a final determination is received.
  • Renew authorizations for ongoing treatment plans before expiration.

Denials, Appeals & Escalations

  • Identify authorization denials and incomplete requests, determine the reason, and gather the information needed for reconsideration or appeal.
  • Coordinate with providers and clinical staff on letters of medical necessity, peer-to-peer reviews, and additional clinical documentation.
  • Escalate urgent, high-value, and at-risk cases to the Prior Authorization Manager according to established protocols.
  • Document payer decisions, reference numbers, effective dates, approved units, and limitations accurately in eClinicalWorks.

Scheduling & Patient Access Support

  • Confirm authorization clearance before services are rendered and communicate status to scheduling and clinic teams.
  • Flag at-risk cases in advance of appointments to prevent avoidable cancellations, rescheduling, and patient dissatisfaction.
  • Verify relevant benefit and coverage information and route financial counseling needs to the appropriate team.
  • Respond promptly and professionally to authorization questions from patients, clinic staff, providers, and payer representatives.

Productivity, Quality & Compliance

  • Maintain accurate, real-time work queues and tracking for pending, approved, denied, appealed, and expired authorizations.
  • Meet established productivity, quality, aging, and turnaround-time standards.
  • Identify recurring payer or workflow issues and share trends with the Prior Authorization Manager.
  • Follow HIPAA, payer, and organizational policies at all times.

QUALIFICATIONS

Required

  • Minimum 2 years of dedicated prior authorization experience in an outpatient specialty healthcare setting.
  • Demonstrated experience independently managing high-volume authorization queues.
  • Direct experience with payer portals, medical necessity requirements, clinical documentation, denials, and appeals.
  • Working knowledge of commercial, Medicare, Medicare Advantage, and Medicaid managed care plans.
  • Experience with eClinicalWorks or a comparable EMR/practice management system.
  • Ability to prioritize time-sensitive cases, manage competing deadlines, and maintain strong attention to detail.
  • Clear written and verbal communication skills and comfort working with clinical teams and payer representatives.

Preferred

  • Prior authorization experience in neurology or infusion services.
  • Experience with EMG, EEG, MRI, Botox, infusion therapies, sleep studies, and related specialty procedures.
  • Experience with WellMed, UnitedHealthcare, Blue Cross Blue Shield of Texas, and Texas Medicaid managed care plans.
  • Experience in a multi-site outpatient specialty practice.
  • CPAR or comparable patient access certification.

COMPENSATION & BENEFITS

Salary Range: Commensurate with experience
Benefits: Medical, dental, vision, PTO, and 401(k)
Employment Type: Full-Time

 

Texas Institute for Neurological Disorders / US Neurology Associates is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.