ZipRecruiter

Log In

1

Prior Authorization Representative Jobs in Texas

Medix

Prior Authorization Pharmacy Technician

Plano, TX · On-site

$22 - $26/hr

The actual posting represents a position at one of our clients. Job Summary Our client is seeking a skilled Prior Authorization Specialist to join their team. The primary responsibility of this role ...

KabaFusion

Authorization Representative

Carrollton, TX · On-site

$16.50 - $21/hr

... authorizations, and complete start‑of‑care documentation. This position protects revenue ... prior to deliveries to ensure accuracy, active coverage and notifies internal departments and ...

Medix

Medical Authorization Specialist

Plano, TX · On-site

$23 - $26/hr

Prior Authorization Status Follow-Up: Proactively contact insurance companies via phone, portals ... The requirements listed below are representative of the knowledge, skill, and/or ability required.

Medix

Prior Auth Specialist/Pharmacy Technician

Plano, TX · On-site

$22 - $26/hr

The actual posting represents a position at one of our clients. Job Summary Our client is seeking a skilled Prior Authorization Specialist to join their team. The primary responsibility of this role ...

next page

Showing results 1-20

All JobsPrior Authorization Representative JobsPrior Authorization Representative Jobs in Texas

Prior Authorization Representative information

See Texas salary details

$22.8K

$41.2K

$71.7K

How much do prior authorization representative jobs pay per year?

As of Aug 9, 2026, the average yearly pay for prior authorization representative in Texas is $41,197.00, according to ZipRecruiter salary data. Most workers in this role earn between $34,900.00 and $40,100.00 per year, depending on experience, location, and employer.

How to become a prior authorization representative?

To become a prior authorization representative, candidates typically need a high school diploma or equivalent and should develop skills in medical terminology, insurance policies, and data entry. Relevant experience in healthcare or insurance billing can be beneficial, and some employers may require familiarity with electronic health record (EHR) systems. Certification is not mandatory but can enhance job prospects and demonstrate expertise in healthcare administration.

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

Prior Authorization Representatives often encounter challenges such as navigating complex insurance policies, managing high volumes of requests, and dealing with time-sensitive cases. Staying up-to-date with payer requirements and utilizing electronic health record (EHR) systems can help streamline the process. Strong communication and organizational skills are essential for collaborating with healthcare providers and insurance companies to ensure timely approvals and minimize delays for patients.

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

AspectPrior Authorization RepresentativeMedical Billing Specialist
CredentialsHigh school diploma; certification often preferredHigh school diploma; certification optional
Work EnvironmentHealthcare offices, insurance companiesMedical offices, billing companies
Primary ResponsibilitiesSecuring insurance approvals for proceduresProcessing and submitting medical claims

The Prior Authorization Representative focuses on obtaining insurance approvals before procedures, while the Medical Billing Specialist handles billing and claims processing after services are rendered. Both roles require knowledge of insurance policies and healthcare documentation, but they differ in their primary functions within the healthcare revenue cycle.

Are prior authorization jobs in high demand?

Prior authorization representative roles are in steady demand due to the increasing need for healthcare cost management and insurance verification. These jobs often require strong attention to detail and familiarity with healthcare systems and electronic health records. The demand is expected to grow as healthcare providers and insurers continue to streamline approval processes.

What does a prior authorization representative do?

A Prior Authorization Representative is responsible for reviewing and processing requests for prior authorization of medical procedures, medications, or services. They work with healthcare providers, insurance companies, and patients to ensure that the necessary documentation is submitted and meets the insurance requirements for approval. Their role helps facilitate timely access to medical care by verifying coverage and resolving any issues that may delay treatment. Excellent communication and organizational skills are important for this position.

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

To thrive as a Prior Authorization Representative, you need a strong understanding of healthcare insurance processes, medical terminology, and prior authorization guidelines, usually supported by a high school diploma or equivalent. Familiarity with healthcare management software, electronic medical records (EMRs), and payer-specific authorization portals is typically required. Attention to detail, problem-solving abilities, and effective communication are standout soft skills for this role. These competencies are essential to ensure timely and accurate processing of authorizations, minimize claim denials, and support patient access to necessary care.
What are popular job titles related to Prior Authorization Representative jobs in Texas? For Prior Authorization Representative jobs in Texas, the most frequently searched job titles are:
What job categories do people searching Prior Authorization Representative jobs in Texas look for? The top searched job categories for Prior Authorization Representative jobs in Texas are:
Prior Authorization Representative jobs near you
Infographic showing various Prior Authorization Representative job openings in Texas as of July 2026, with employment types broken down into 1% As Needed, 76% Full Time, 20% Part Time, 1% Temporary, and 2% Contract. Highlights an 93% Physical, 1% Hybrid, and 6% Remote job distribution, with an average salary of $41,197 per year, or $19.8 per hour.

Prior Authorization Representative

US Neurology Associates

Frisco, TX

$35K - $40K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 4 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.