Strategic Prior Authorization Specialist

Senior PsychCare; Houston (TX); On-site; USD 30,000 - 39,000; Full time

Job summary

Senior PsychCare is seeking an Authorization Specialist to manage the prior authorization and referral workflow, ensuring accurate submissions, timely follow-ups, and compliance with payer requirements. You will work with providers, insurance payers, and Revenue Cycle teams to obtain approvals and address denials.

If you are detail-oriented, experienced with ICD-10 and CPT coding, and able to manage multiple authorizations in a fast-paced setting, join us to help maintain smooth patient access

Qualifications

• Minimum of three years in healthcare prior authorizations.
• Experience with managed care organizations (MCOs) preferred.
• Strong organizational and time-management skills with attention to detail.
• Proficiency in health insurance coverage, payer requirements, and billing practices.

Responsibilities

• Prioritize incoming authorization requests based on urgency and guidelines.
• Initiate, verify, and complete prior authorizations and referrals per payer rules.
• Resolve day-to-day issues related to authorizations and referrals promptly.
• Monitor provider network status for in-network/out-of-network issues affecting authorization or reimbursement.
• Obtain required authorizations via payer portals, fax, or phone and follow up timely.
• Communicate approvals, denials, and status updates to relevant departments.

Skills

In-network plans

Insurance verification

Prior authorization

ICD-10 CPT coding

Education

High School Diploma or GED

Tools

Microsoft Office

EMR systems

Job description

Senior PsychCare is seeking an Authorization Specialist to manage the prior authorization and referral workflow, ensuring accurate submissions, timely follow-ups, and compliance with payer requirements. You will work with providers, insurance payers, and Revenue Cycle teams to obtain approvals and address denials.

If you are detail-oriented, experienced with ICD-10 and CPT coding, and able to manage multiple authorizations in a fast-paced setting, join us to help maintain smooth patient access