Top 36 Prior authorization specialist Jobs in Frisco, Tx

Prior Authorization Lead
Texas Institute for Neurological Disorders —Frisco, TX
- Full-time
- 5 years
- Clinic
- Neurology
- Health insurance
- Dental insurance
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Acute Clearance Specialist - Intake Coordinator - Remote
Soleo Health Inc —Frisco, TX
- $23 - $27 an hour
- Urgently hiring
- Remote
- Microsoft Word
- HIPAA
- Mid-level
- Paid parental leave
- Health savings account
Quick Apply
Insurance Authorization Specialist
KidsCare Home Health —Dallas, TX
- Full-time
- Spanish
- Computer literacy
- English
- Health insurance
- Dental insurance
22h
Referral Coordinator (CPhT)
CSI Pharmacy —Plano, TX
- $26 - $28 an hour
- Full-time
- Pass drug screening
- Mid-level
- Office
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Prior Authorization Specialist - Interventional Spine / Pain Medicine
Virtuoso Spine & Joint —Carrollton, TX
- $19 - $25 an hour
- Part-time
- Spanish
- Customer service
- Medical office experience
- Paid time off
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9d
Medical Front Office Specialist
US Heart & Vascular —Frisco, TX
- Full-time
- Clinic
- Entry level
- Under 1 year
Surgical Patient Coordinator
Thrive Reconstructive Surgery —Plano, TX
- $48,000 - $55,000 a year
- Weekends as needed
- Surgery
- Medical office experience
- HIPAA
- Paid training
- Health insurance
Quick Apply
14d
Supporting Documentation Specialist
Pediatric Home Service —Richardson, TX
- Online Application
- 21 years or older
- Children
- Home Health
- Disability insurance
- Health insurance
Quick Apply
Pharmacy Technician - Prior Authorization Specialist
Cloud Rx Pharmacy —Farmers Branch, TX
- Full-time
- Mid-level
- In-person
- Medical terminology
Quick Apply
Patient Access Specialist, Floater PRN, (Richardson)
Methodist Hospital for Surgery —Richardson, TX
- Part-time
- Microsoft Outlook
- Ability to walk for extended periods
- Computer literacy
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9d
Patient Access Specialist, PRN, (Denton-Mesa)
Methodist Hospital for Surgery —Denton, TX
- Part-time
- Microsoft Outlook
- Ability to walk for extended periods
- Computer literacy
Quick Apply
Ambulatory Surgery Center Scheduler
Willowbend Surgery Center —Plano, TX
- From $24 an hour
- Full-time
- Background check
- Customer service
- Medical office experience
- Health insurance
- Dental insurance
Quick Apply
8d
Intake Navigator
NAUTILUS HEALTH MANAGEMENT LLC - 348193 —Irving, TX
- $20 - $21 an hour
- Mid-level
- High school diploma or GED
- Home Health
Quick Apply
Claims Reconciliation Specialist
OMS MEDICAL BILLING LLC —Addison, TX
- $23 - $27 an hour
- Full-time
- Mid-level
- Office
- High school diploma or GED
- Dental insurance
- 401(k)
Quick Apply
Medical Billing Associate, Billing Specialist
THE WARREN CENTER, INC. —Richardson, TX
- $19 - $20 an hour
- Full-time
- Word processing
- Basic math
- HIPAA
Quick Apply
Receptionist / Patient Coordinator
Azouz Plastic and Cosmetic Surgery —Dallas, TX
- $18 - $20 an hour
- Part-time
- Hybrid work
- Spanish
- Google Workspace
- Microsoft Outlook
- Flexible schedule
Quick Apply
Genetic Counselor, Benefits Investigation
FULGENT THERAPEUTICS LLC —Coppell, TX
- Full-time
- Mid-level
- Master's degree
- Communication skills
Quick Apply
Credentials Liaison Specialist
Bracane Co —Plano, TX
- Nursing
- 5 years
- Pass drug screening
Quick Apply
Medical Front Office and Referral Coordinator
MEDICAL SPECIALISTS ASSOCIATED —Dallas, TX
- $18 - $20 an hour
- Ability to walk for extended periods
- Internal Medicine
- HIPAA
Quick Apply
AR Follow-up & Denial Management
Credence Resource Management —Richardson, TX
- $20 - $22 an hour
- Full-time
- HIPAA
- Mid-level
- 3 years
- 401(k)
- Paid time off
Quick Apply
8d

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prior authorization specialist jobs near frisco, tx

Prior Authorization Lead

Texas Institute for Neurological Disorders
Frisco, TX

Quick Apply

Job Details

Full-time

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance

Qualifications

Health insurance authorizations
Appeals
Patient scheduling systems
Insurance prior authorization
Medicare
Managed care organization experience
Medicaid health insurance
Pre-authorization review for utilization management
Medicare regulations
Quality improvement
Medicaid regulations
Medicaid
Neurology
Process management
Cross-functional communication

Full Job Description

PRIOR AUTHORIZATION LEAD

Texas Institute for Neurological Disorders / US Neurology Associates

Department: Revenue Cycle / Operations │ Schedule: Full-Time, Monday–Friday │ Location: On-Site, Frisco

POSITION SUMMARY

The Prior Authorization Lead is a senior individual contributor responsible for owning and managing the end-to-end prior authorization workflow across a multi-site outpatient neurology practice serving patients throughout the Dallas Fort Worth area. The individual in this role will own hands-on execution, optimize current workflows, and serve as the subject matter expert as our clinical operations scale. As the department expands, this role is ultimately expected to lead a team of prior authorization specialists. This role requires expertise in neurology-specific (or similar) authorization requirements and a track record of managing high-volume, complex payer environments with minimal supervision.

The Prior Authorization Lead will bring established payer knowledge, process discipline, and the needed clinical vocabulary to communicate effectively with providers, clinical staff, and payer representatives in a fast-paced neurology environment.

KEY RESPONSIBILITIES

Prior Authorization Management

Own end-to-end prior authorization for all physician visits, procedures (EMG, EEG, infusions, Botox/injections), and ancillary services across multiple clinic locations
Initiate, track, escalate, and close authorizations within payer-required timelines — with particular attention to WellMed, Medicare Advantage, and Texas Medicaid managed care plans
Manage denial and appeal workflows: identify denial trends, gather supporting clinical documentation, and coordinate with providers and clinical staff to reverse denials
Monitor and proactively renew authorizations for ongoing treatment plans before expiration
Maintain complete and accurate authorization records in eClinicalWorks (eCW)

Workflow Integrity & Scheduling Protection

Ensure no patient is scheduled for procedures requiring authorization without verified clearance
Identify and flag high-risk scheduling exceptions prior to appointment confirmation
Work with scheduling leadership to prevent downstream rescheduling due to authorization failure
Serve as the escalation point for authorization-related scheduling conflicts and urgent cases

Benefits Verification

Verify insurance benefits prior to scheduling, including coverage, co-pays, deductibles, and out-of-pocket requirements
Identify patients requiring financial counseling or payment plan setup and facilitate appropriate referral
Confirm payer-specific requirements at the point of scheduling to prevent point-of-service surprises

Communication & Coordination

Serve as the primary internal liaison between scheduling, clinical staff, and external payer and authorization teams
Serve as the internal subject matter expert, educating and advising scheduling and clinical staff on payer-specific authorization requirements and best practices.
Proactively communicate authorization status to the scheduling team, flagging at-risk cases within 72 hours of appointment
Reduce authorization-related call and email volume reaching the scheduling queue by resolving upstream issues

Documentation & Reporting

Maintain an organized, real-time tracking system for all pending, approved, denied, and appealed authorizations
Identify process improvement opportunities and optimize workflows to eliminate authorization-related delays and maximize clearance efficiency.
Produce regular status reports for operations leadership on queue volume, turnaround times, denial rates, and appeal outcomes

QUALIFICATIONS

Required

Minimum 5 years of prior authorization experience in an outpatient healthcare setting
Demonstrated experience managing high-volume, complex authorization workflows with minimal supervision
Strong working knowledge of commercial, Medicare, Medicare Advantage, and Medicaid managed care payer requirements
Proficiency with eClinicalWorks (eCW) or a comparable EMR/practice management system
Experience with payer portals including Availity, NaviMedix, and payer-specific platforms
Ability to manage competing priorities and meet tight deadlines in a fast-paced multi-site environment
Strong written and verbal communication skills with the ability to engage clinical staff, schedulers, and payer representatives effectively

Preferred

Prior authorization experience in outpatient neurology - strongly preferred
Familiarity with neurology-specific procedures and their authorization requirements (EMG, EEG, infusion therapies, Botox, sleep studies)
Experience with WellMed, UnitedHealthcare, BCBS Texas, and Texas Medicaid managed care plans
CPAR (Certified Patient Access Representative) or equivalent certification
Experience in a multi-site outpatient specialty practice

COMPENSATION & BENEFITS
Salary Range

Commensurate with experience

Location

On-Site, Frisco

Benefits

Medical, dental, vision, PTO, 401(k)

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.

Benefits:

401(k)
Dental insurance
Health insurance
Paid time off
Vision insurance

Work Location: In person

Quick Apply

Refine Your Search

prior authorization specialist jobs in frisco, tx

Prior Authorization Lead

Acute Clearance Specialist - Intake Coordinator - Remote

Insurance Authorization Specialist

Referral Coordinator (CPhT)

Prior Authorization Specialist - Interventional Spine / Pain Medicine

Medical Front Office Specialist

Surgical Patient Coordinator

Supporting Documentation Specialist

Pharmacy Technician - Prior Authorization Specialist

Patient Access Specialist, Floater PRN, (Richardson)

Patient Access Specialist, PRN, (Denton-Mesa)

Ambulatory Surgery Center Scheduler

Intake Navigator

Claims Reconciliation Specialist

Medical Billing Associate, Billing Specialist

Receptionist / Patient Coordinator

Genetic Counselor, Benefits Investigation

Credentials Liaison Specialist

Medical Front Office and Referral Coordinator

AR Follow-up & Denial Management

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