Authorization & Insurance Verification Specialist

Socket.dev; Houston (TX); On-site; USD 42,000 - 66,000; Full time

Job summary

Texas Regional Physicians is seeking an Insurance Verification & Authorization Specialist to join our team. The role focuses on confirming patient insurance coverage, obtaining prior authorizations, referrals, and ensuring approvals before services.

The ideal candidate will be highly organized, able to manage a high-volume, time-sensitive workload, and knowledgeable about payer policies and online portals. A minimum of 2 years in insurance verification or medical billing is required.

Qualifications

• 2 years of insurance verification or medical billing experience
• 2 years of experience in a medical/healthcare environment
• Experience obtaining prior authorizations and referrals preferred
• Familiarity with payer policies and online portals
• Strong communication and organizational skills

Responsibilities

• Verify insurance coverage, eligibility, and benefits prior to appointments
• Verify COB and resolve discrepancies
• Submit and manage prior authorization requests
• Obtain referrals and GAP exceptions as required
• Track and follow up on pending authorizations
• Provide clinical documentation to insurers to support authorizations
• Initiate appeals for denials and follow through to resolution
• Review payer policies to determine authorization requirements
• Maintain communication with clinical and scheduling teams about status
• Assist patients with insurance questions and update information

Skills

Verbal communication

Written communication

Customer service

Attention to detail

Time management

Multitasking

Education

High School Diploma or GED

Tools

Microsoft Excel

Microsoft Word

Job description

Texas Regional Physicians is seeking an Insurance Verification & Authorization Specialist to join our team. The role focuses on confirming patient insurance coverage, obtaining prior authorizations, referrals, and ensuring approvals before services.

The ideal candidate will be highly organized, able to manage a high-volume, time-sensitive workload, and knowledgeable about payer policies and online portals. A minimum of 2 years in insurance verification or medical billing is required.