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Prior Authorization Nurse Jobs in Spring, TX (NOW HIRING)

A-Line Staffing Solutions

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Healthcare Authorization Specialist

Houston, TX · On-site

$19/hr

The team receives, reviews, validates, and creates prior authorization requests across multiple Medicaid lines of business, including STAR, STAR+, CHIP, STAR Kids, and STAR Health. Authorization ...

New

Prelude Fertility

Authorization Specialist

Houston, TX · On-site

$17.25 - $23/hr

Our Authorization Specialist will be responsible for providing a great patient experience by checking patient eligibility and initiating prior authorizations. This includes utilizing online resources ...

Prelude Fertility

Authorization Specialist

Houston, TX · On-site

$16.25 - $21.50/hr

Our Authorization Specialist will be responsible for providing a great patient experience by checking patient eligibility and initiating prior authorizations. This includes utilizing online resources ...

Longevity Health Plan

RN Field Coordinator

Houston, TX · On-site

Support transitions of care, assist with prior authorization requests, and help members access services outside the nursing facility. * Communicate with patients, families, and physicians as ...

New

Emerus

Insurance Authorization Specialist

The Woodlands, TX

$16.50 - $22/hr

Complete daily authorization requirements from all hospitalizations * Reviews admissions for accuracy of insurance, coordination of benefits, and status * Obtains clinicals, diagnosis information and ...

Emerus

Insurance Authorization Specialist

The Woodlands, TX · On-site

$16 - $21.50/hr

Complete daily authorization requirements from all hospitalizations * Reviews admissions for accuracy of insurance, coordination of benefits, and status * Obtains clinicals, diagnosis information and ...

Emerus

Insurance Authorization Specialist

The Woodlands, TX · On-site

$16.50 - $22/hr

Complete daily authorization requirements from all hospitalizations * Reviews admissions for accuracy of insurance, coordination of benefits, and status * Obtains clinicals, diagnosis information and ...

Oshi Health

Registered Nurse - GI

Houston, TX

... coverage/prior authorization barriers. * Evaluate refill appropriateness, identifying cases that ... Represent nursing workflows in interdisciplinary alignment meetings and quality reviews. Operations ...

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All JobsPrior Authorization Nurse JobsPrior Authorization Nurse Jobs in Spring, TX

Prior Authorization Nurse information

See Spring, TX salary details

$15

$34

$58

How much do prior authorization nurse jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for prior authorization nurse in Spring, TX is $34.36, according to ZipRecruiter salary data. Most workers in this role earn between $26.30 and $38.51 per hour, depending on experience, location, and employer.

What is a prior authorization nurse?

Prior Authorization Nurses are registered nurses who evaluate medical requests and determine if procedures, medications, or services meet clinical guidelines for insurance coverage. They work closely with healthcare providers, insurance companies, and patients to ensure that prior authorization requirements are met before treatments or medications are approved. Their role helps streamline care delivery, reduce unnecessary costs, and ensure patients receive appropriate, covered services in a timely manner.

What does a prior authorization nurse do?

As a prior authorization nurse, you review requests for authorization for specific medications, treatments, or surgeries. Your duties include reviewing medical records and documents related to the application. You consider each prior authorization request and collect evidence and patient information to support your decision. You communicate with the insurance provider to obtain additional information if needed. Your responsibilities in this position also involve ensuring the authorization meets regulations and requirements and contractual obligations of all parties involved. Your job can also require coordinating with administrators and healthcare providers to gain necessary information and ensure that patients receive authorized care.

What are the key skills and qualifications needed to thrive as a prior authorization nurse, and why are they important?

To thrive as a Prior Authorization Nurse, you need a solid background in nursing, knowledge of insurance guidelines, and an active RN license. Familiarity with prior authorization software, electronic health records (EHRs), and payer-specific portals is typically required. Strong attention to detail, critical thinking, and effective communication help in collaborating with providers and navigating complex cases. These skills are essential to ensure accurate, timely authorization of medical services, which directly impacts patient care and healthcare reimbursement.

What are some common challenges faced by prior authorization nurses in coordinating with insurance providers?

Prior Authorization Nurses often encounter challenges such as navigating varying requirements from different insurance providers, managing tight turnaround times for approvals, and ensuring that clinical documentation is thorough and accurate. Effective communication and attention to detail are essential, as missing or unclear information can delay authorizations. Building collaborative relationships with providers, physicians, and insurance representatives helps streamline the process and improves patient outcomes.

What is the difference between Prior Authorization Nurse vs Utilization Review Nurse?

AspectPrior Authorization NurseUtilization Review Nurse
CredentialsRN license, possibly certifications in case managementRN license, certifications in case management or utilization review
Work EnvironmentHealthcare facilities, insurance companies, or telehealthHospitals, insurance companies, or managed care organizations
Job FocusPre-authorization of specific procedures or treatmentsReviewing medical necessity and appropriateness of ongoing care

While both roles involve nursing expertise and work within healthcare and insurance settings, the Prior Authorization Nurse primarily focuses on obtaining approval before procedures, whereas the Utilization Review Nurse evaluates ongoing care for medical necessity. Understanding these differences helps in choosing the right career path or job search focus.

More about Prior Authorization Nurse jobs

What are popular job titles related to Prior Authorization Nurse jobs in Spring, TX?

For Prior Authorization Nurse jobs in Spring, TX, the most frequently searched job titles are:

What job categories do people searching Prior Authorization Nurse jobs in Spring, TX look for?

The top searched job categories for Prior Authorization Nurse jobs in Spring, TX are:

What cities near Spring, TX are hiring for Prior Authorization Nurse jobs?

Cities near Spring, TX with the most Prior Authorization Nurse job openings:

Prior Authorization Nurse jobs near you
Infographic showing various Prior Authorization Nurse job openings in Spring, TX as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 14% Part Time, 1% Temporary, and 2% Contract. Highlights an 93% Physical, 1% Hybrid, and 6% Remote job distribution, with an average salary of $71,477 per year, or $34.4 per hour.

Healthcare Authorization Specialist

A-Line Staffing Solutions

Houston, TX • On-site

$19/hr

Full-time

Medical, Dental, Vision

This job post has expired today. Applications are no longer accepted.

Job description

Healthcare Authorization Specialist

Location: Fully Remote, Texas

Pay: $19.00/hour

Schedule: Monday-Friday, 8:00 AM-5:00 PM CST

Employment Type: Initial W2 Assignment with potential for extension or conversion to FTE based on business needs

Job Overview

This role supports the authorization intake function for a large managed care organization serving Texas Medicaid members. The team receives, reviews, validates, and creates prior authorization requests across multiple Medicaid lines of business, including STAR, STAR+, CHIP, STAR Kids, and STAR Health. Authorization Specialists help ensure requests are accurately entered, properly routed, and processed within required turnaround times to support timely access to care.

The Authorization Intake team works in a fast-paced and collaborative environment focused on quality, compliance, productivity, and customer service. Specialists work closely with clinical review, determinations, correspondence, provider relations, and leadership teams while managing authorization inventory and responding to changing business needs.

Key Responsibilities

  • Receive, review, and validate prior authorization requests for multiple Texas Medicaid programs.
  • Research member and provider information to ensure authorization requests are complete and accurate.
  • Review requests for required documentation and information.
  • Create and build authorizations in the appropriate systems.
  • Conduct provider outreach to obtain missing information or documentation.
  • Route authorization requests to the appropriate teams based on established workflows.
  • Document processing activities and provider communications accurately.
  • Manage worklist inventory and prioritize requests to meet regulatory and business turnaround time requirements.
  • Support transition-of-care activities and authorization-related special initiatives.
  • Assist with provider education and inquiries related to authorization processing.
  • Work collaboratively with clinical reviewers, provider relations, correspondence, and operations leadership.
  • Follow applicable healthcare regulations, business requirements, and department procedures.
  • Maintain productivity and quality standards while minimizing processing errors and preventing overdue requests.

Qualifications

  • High school diploma or GED required.
  • 1-2 years of prior authorization experience required.
  • Experience with provider outreach.
  • Experience with healthcare insurance verification.
  • Knowledge of ICD-10 codes.
  • Knowledge of CPT codes.
  • Healthcare insurance, managed care, Medicaid, or utilization management experience is preferred.
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About A-Line Staffing Solutions

Sourced by ZipRecruiter

A-Line Staffing Solutions is an established full-service recruiting and staffing provider that operates in the industry of human resources and recruitment. Based in Utica, Michigan, A-Line Staffing Solutions has been committed to its mission of providing innovative and effective workforce solutions since its foundation. The company specializes in providing high-quality staffing solutions for a range of disciplines, including Information Technology, Professional, Administrative, Healthcare, and more. A-Line prides itself on its ability to offer comprehensive and tailored staffing solutions in line with the varying needs of different businesses, which has played a crucial role in the company's growth and success.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Utica, MI, US

Year founded

2004

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