Top 26 Authorization specialist Jobs in Edinburg, Tx

PRIOR AUTHORIZATION AND REFERRAL SPECIALIST
The University of Texas Rio Grande Valley —Edinburg, TX
- Weekends as needed
- Spanish
- Research
- High school diploma or GED
7d
Medical Office Specialist-Edinburg ENT
Driscoll Health —Edinburg, TX
- Full-time
- Mid-level
- High school diploma or GED
- Organizational skills
8d
Clinic Office Specialist - FT - Days - Oncology Nursing
DHR Health —Edinburg, TX
- Full-time
- Spanish
- Basic math
- English
Medical Office Specialist/Insurance Verification Specialist
Texas Digestive Specialists —McAllen, TX
- From $12 an hour
- 8 hour shift
- Bilingual
- Private practice
- Surgery
- Health insurance
- Dental insurance
Quick Apply
MEDICAL REFERRAL COORDINATOR
The University of Texas Rio Grande Valley —McAllen, TX
- Weekends as needed
- Management
- Medical office experience
- Mid-level
6d
Medical Office Specialist- McAllen Medical Plaza
Driscoll Health —McAllen, TX
- Full-time
- Spanish
- BLS Certification
- Mid-level
MOS
JUSTIN FAYE, MD —McAllen, TX
- $14 - $17 an hour
- Full-time
- Bilingual
- HIPAA
- Mid-level
Quick Apply
15h
BILLING CLERK
The University of Texas Rio Grande Valley —Edinburg, TX
- Weekends as needed
- Spanish
- Microsoft Excel
- Microsoft Outlook
13d
Billing and Collections Specialist II - FT - Days -Denials Management
DHR Health —Edinburg, TX
- Weekends as needed
- Spanish
- Microsoft Excel
- Hospital
Clinic Office Specialist - FT - Days - Oncology Shared
DHR Health —Edinburg, TX
- Full-time
- Spanish
- Basic math
- English
Surgery Coordinator - FT - Days - DHR Vein Institute
DHR Health —McAllen, TX
- Full-time
- Microsoft Excel
- Surgery
- Basic math
Clinic Office Specialist,- FT- Days-Pelvic Floor Therapy
DHR Health —Edinburg, TX
- Full-time
- Spanish
- English
- High school diploma or GED
6d
Clinic Office Specialist - FT - Days - Dr. Changlani
DHR Health —Edinburg, TX
- Full-time
- Spanish
- Basic math
- English
Billing and Collections Specialist, RMF Revenue Cycle
DHR Health —Edinburg, TX
- Weekends as needed
- Hospital
- Basic math
- HIPAA
Clinic Office Specialist - FT - Days - Neuro Spine Patel
DHR Health —Edinburg, TX
- Full-time
- Spanish
- Basic math
- English
Authorizations Specialist
XCELL ORTHOPAEDICS INSTITUTE OF SPORTS PERFORMANCE LLC —McAllen, TX
- $12.50 - $14.00 an hour
- Full-time
- Microsoft Outlook
- Mid-level
- High school diploma or GED
- Opportunities for advancement
Quick Apply
8d
Clinic Office Specialist, DHR Joslin/Twahirwa
DHR Health —Edinburg, TX
- Full-time
- Spanish
- English
- Mid-level
6h
Clinic Office Specialist, Valley Cardio Shared
DHR Health —McAllen, TX
- Full-time
- Spanish
- Basic math
- English
4d
Front Office- Treatment Coordinator (Bilingual)
Community Dental Partners —Weslaco, TX
- $13 - $15 an hour
- Full-time
- Bilingual
- Dental office
- High school diploma or GED
- Paid training
- Health savings account
Quick Apply

Discover related jobs

Based on your search for authorization specialist jobs.

Medical Biller
Health Care Unlimited, Inc. —McAllen, TX
Ensure compliance with federal, state, and payer‑specific billing regulations. General knowledge of medical coding and billing software.
$15.80 - $18.20 an hour
Quick Apply
4d
Medical Office Specialist/Insurance Verification Specialist
Texas Digestive Specialists —McAllen, TX
Looking for a full-time receptionist for a medical practice. Previous experience in a medical office is preferred. Pay: From $12.00 per hour.
From $12 an hour
Quick Apply

Show more related jobs

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

Prior Authorization Specialist
Equitas Health, Inc. —Columbus, OH
Reliable transportation, driver’s license and proof of auto insurance required. Essential job functions include, but are not limited to, driving or having…
$18.13 - $21.78 an hour
Quick Apply
Utilization Management Specialist
ST VINCENT FAMILY SERVICES —Columbus, OH
Associate's Degree required; Bachelor's Degree preferred in Healthcare Administration, Business Administration, Social Work, Public Health, or related field.
Quick Apply

Show more jobs in cities nearby

I want to receive the latest job alert for authorization specialist in edinburg, tx

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

authorization specialist jobs near edinburg, tx

Registered Nurse Oncology jobs in Edinburg, TX

Office Specialist jobs in McAllen, TX

Office Specialist jobs in Edinburg, TX

Revenue Cycle Specialist jobs in Edinburg, TX

Referral Coordinator jobs in McAllen, TX

Front Office Coordinator jobs in Baltimore, MD

Office Manager jobs in Fresno, CA

Front Office Coordinator jobs in Toledo, OH

Office jobs in Corinth, MS

Front Office Coordinator jobs in Three Rivers, MI

Front Office Coordinator jobs in Orlando, FL

Front Desk Receptionist jobs in Upper Marlboro, MD

Registered Nurse Rn jobs in Forney, TX

Oncology Infusion Nurse jobs in California

Registered Behavior Technician jobs in Wilmington, NC

Registered Nurse jobs in Chesterfield, VA

Customer Success Specialist jobs in Chicago, IL

Office Specialist jobs in Houston, TX

Office jobs in Everett, WA

Office Specialist jobs in West Columbia, SC

PRIOR AUTHORIZATION AND REFERRAL SPECIALIST

The University of Texas Rio Grande Valley -
Edinburg, TX

Apply Now

Job Details

Full-time
7 days ago

Qualifications

Overseeing health insurance pre-certification
Medicare
Commercial insurance knowledge
High school diploma or GED
Medicaid health insurance
Healthcare referral management
Medicaid
Health insurance referral requirements

Full Job Description

Number of Vacancies

Location

Edinburg, Texas

Department

School of Medicine/ Revenue Cycle

FTE

1.0

FLSA

Non-Exempt

Scope of Job

Responsible for obtaining and processing all prior authorizations and referrals and entering the completed referral into the electronic medical record system for claims adjudication to ensure services are validated.

Description of Duties

Processes prior authorizations and referral requests in a timely manner, prior to the patients’ services being rendered.
Responsible for researching patient member benefits, additional coverages, coverage limitations, and general coverage allowances to obtain the necessary authorizations and referrals for patient services.
Obtains and receives referral requests from providers and health plans related to services for patient visits and procedures.
Verifies member eligibility and benefits via the health plan provider online portals or health plan provider eligibility services via fax or phone and enters the information into the EMR system accurately for authorization tracking.
Notifies the necessary parties within the required timeframe for routine and urgent requests for services.
Communicates with patients to effectively educate them on any limitations or additional services that may require contact with their insurance carrier to ensure coverage.
Communicates with providers, physicians, and other medical personnel regarding necessary documentation, CPT codes, diagnoses codes, or other information required to obtain the necessary authorizations or referrals.
Communicates with patient service representatives to obtain or correct patient demographics as needed.
Communicates authorization information and coverage to appropriate departmental staff in a timely manner.
Communicates effectively with health plans, payor representatives, and network and claims department staff to resolve complex authorization issues.
Coordinates with health plans and payor representatives for outpatient, inpatient, DME discharge planners, home health providers, and other services as needed when applicable.
Is a source of knowledge for primary care providers regarding specialist referrals.
Performs other duties as assigned.

Supervision Received

General supervision from assigned supervisor.

Supervision Given

Direct supervision of assigned staff.

Required Education

High School diploma/GED.

Preferred Education

None

Licenses/Certifications

None

Required Experience

One (1) year of experience processing prior authorizations and referrals in a medical setting. Knowledge of interpreting commercial insurance coverages to include: Medicaid and Medicare.

Preferred Experience

Bilingual, Spanish speaking preferred.

Equipment

Use of standard office equipment including knowledge of Microsoft Office and previous use of EMR (Electronica medical record systems).

Working Conditions

Needs to be able to successfully perform all required duties. Office/Clinic Environment; some travel and weekend work is required. Exerting up to 10 pounds of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. UTRGV is a distributed institution, which requires presence at multiple locations throughout the Rio Grande Valley.

Other

Exceptional computer skills and experience are required. The ability to work independently with minimal supervision and strong organizational skills with attention to detail is necessary to ensure efficient and quality operations. Ability to interpret medical insurance coverages. Strong knowledge of insurance terminology.

Physical Capabilities

None.

Employment Category

Full-Time

Minimum Salary

Commensurate with Experience

Posted Salary

Commensurate with Experience

Position Available Date

08/17/2026

Grant Funded Position

If Yes, Provide Grant Expiration Date

Posting Detail Information

EEO Statement

It is the policy of The University of Texas Rio Grande Valley to promote and ensure equal employment opportunities for all individuals without regard to race, color, national origin, sex, age, religion, disability, sexual orientation, gender identity or expression, genetic information or protected veteran status. In accordance with the requirements of Title VII of the Civil Rights Act of 1964, the Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, and the Americans with Disabilities Act of 1990, as amended, our University is committed to comply with all government requirements and ensures non-discrimination in its education programs and activities, including employment. We encourage women, minorities and differently abled persons to apply for employment positions of interest.

Special Instructions to Applicants

Dear Applicant, Human Resources will not be held responsible for redacting any confidential information from the documents you attach with your application. The confidential information includes the following: *Date of Birth *Social Security Number *Gender *Ethnicity/Race Please make sure that you omit this information prior to submission. We are advising that Human Resources will be forwarding your application to the department as per your submission. If you have any questions, please do not hesitate to contact us at (956)665-8880 and/or [email protected].

Additional Information

UTRGV is a distributed location institution and working location is subject to change based on need.

All UTRGV employees are required to have a criminal background check (CBC). Incomplete applications will not be considered.

Substitutions to the above requirements must have prior approval from the VP of HR & Regulatory Affairs.

Apply Now

Refine Your Search

authorization specialist jobs in edinburg, tx

PRIOR AUTHORIZATION AND REFERRAL SPECIALIST

Medical Office Specialist-Edinburg ENT

Clinic Office Specialist - FT - Days - Oncology Nursing

Medical Office Specialist/Insurance Verification Specialist

MEDICAL REFERRAL COORDINATOR

Medical Office Specialist- McAllen Medical Plaza

MOS

BILLING CLERK

Billing and Collections Specialist II - FT - Days -Denials Management

Clinic Office Specialist - FT - Days - Oncology Shared

Surgery Coordinator - FT - Days - DHR Vein Institute

Clinic Office Specialist,- FT- Days-Pelvic Floor Therapy

Clinic Office Specialist - FT - Days - Dr. Changlani

Billing and Collections Specialist, RMF Revenue Cycle

Clinic Office Specialist - FT - Days - Neuro Spine Patel

Authorizations Specialist

Clinic Office Specialist, DHR Joslin/Twahirwa

Clinic Office Specialist, Valley Cardio Shared

Front Office- Treatment Coordinator (Bilingual)

Discover related jobs

Explore jobs in cities nearby

I want to receive the latest job alert for authorization specialist in edinburg, tx

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected