Healthcare Insurance Verification & Authorization Specialist

Texas Regional Physicians; Houston (TX); On-site; USD 40,000 - 65,000; Full time

Job summary

Texas Regional Physicians is seeking an Insurance Verification & Authorization Specialist to join our Houston-area team. The role focuses on verifying insurance coverage and benefits, obtaining prior authorizations and referrals, and managing a high-volume workload with accuracy.

You will support scheduling with timely eligible information and documentation for approvals. The ideal candidate is organized, detail-oriented, and proficient with payer portals and medical billing practices.

Qualifications

• High School Diploma or GED required.
• 2+ years of prior insurance verification or medical billing experience required.
• Experience obtaining prior authorizations and referrals preferred.
• Strong computer skills including Excel and Word.

Responsibilities

• Verify patient insurance coverage, eligibility, and benefits prior to scheduled appointments.
• Verify COB and resolve discrepancies as needed.
• Submit and manage prior authorization requests for applicable services.
• Obtain referrals and GAP exceptions as required by carriers.
• Track, prioritize, and follow up on pending authorizations to ensure timely completion.
• Provide required documentation to carriers to support authorization requests.
• Initiate appeals for upfront denials and follow through to resolution.
• Review payer policies to determine authorization requirements.
• Communicate status with clinical and scheduling teams.

Skills

Insurance verification

Prior authorizations

Payer policies knowledge

Time management

Multitasking

Communication skills

Customer service

Teamwork

Education

High School Diploma or GED

2+ years in medical billing/insurance verification

Tools

Microsoft Excel

Microsoft Word

Payer portals

Job description

Texas Regional Physicians is seeking an Insurance Verification & Authorization Specialist to join our Houston-area team. The role focuses on verifying insurance coverage and benefits, obtaining prior authorizations and referrals, and managing a high-volume workload with accuracy.

You will support scheduling with timely eligible information and documentation for approvals. The ideal candidate is organized, detail-oriented, and proficient with payer portals and medical billing practices.