Top 443 Authorization representative Jobs in Houston, Tx

Referral Navigator Representative - Kelsey Seybold Clinic - Utilization Review - Remote
Optum —Pearland, TX
- $18 - $32 an hour
- Full-time
- Remote
- Medical office experience
- Pass drug screening
- Mid-level
Quick Apply
9d
Patient Access Representative II - TIRR - Katy Rehab
Memorial Hermann Health System —Houston, TX
- Full-time
- Mid-level
- High school diploma or GED
- Rehabilitation center
4d
Senior Call Center Representative - Member Services
Texas Children's Hospital —Bellaire, TX
- Full-time
- HIPAA
- Mid-level
- High school diploma or GED
Supplemental Patient Access Representative - Northeast (Part - time)
Memorial Hermann Health System —Humble, TX
- Part-time
- Mid-level
- High school diploma or GED
- Typing
4d
Patient Access Representative - Full Time
Memorial Hermann Health System —Humble, TX
- Full-time
- Mid-level
- High school diploma or GED
- Typing
4d
Referral Navigator Representative - Kelsey Seybold Clinic - Utilization Review
Optum —Pearland, TX
- $18 - $32 an hour
- Full-time
- Remote
- Medical office experience
- Pass drug screening
- Mid-level
Quick Apply
4d
Patient Benefits Representative
Texas Oncology —Houston, TX
- Full-time
- Microsoft Excel
- HIPAA
- Finance
3d
BEHAVIOR SPECIALIST - NON-BCBA
International Leadership of Texas —Houston, TX
- $68,000 - $80,000 a year
- Full-time
- Background check
- Residential
- US work authorization
- Health savings account
- AD&D insurance
Senior Patient Services Representative - Psychiatry (Medical Center)
Houston Methodist Specialty Physician Group —Houston, TX
- Full-time
- Psychiatry
- Inventory management
- Word processing
Patient Services Representative - Primary Care (Medical Center)
Houston Methodist Primary Care Group —Houston, TX
- Full-time
- Inventory management
- Word processing
- Writing skills
11d
Card Dispute Representative
FIRST SERVICE CREDIT UNION —Houston, TX
- Extended hours
- High school
- Writing skills
- Research
Quick Apply
Patient Access Representative II (Full-time)
Memorial Hermann Health System —Humble, TX
- Full-time
- Hospital
- Mid-level
- High school diploma or GED
4d
Patient Access Representative I/II/Sr. - Bellaire Station
UTHealth Houston —Houston, TX
- Customer service
- Medical office experience
- High school diploma or GED
- Free parking
- Health insurance
EDI Representative
US Physical Therapy —Houston, TX
- Full-time
- Hybrid work
- Customer service
- Research
- Office
- Health insurance
- Dental insurance
Quick Apply
10d
Outpatient Intake Coordinator
Womens Home Inc —Houston, TX
- $60,000 - $75,000 a year
- Full-time
- Spanish
- Licensed Clinical Social Worker
- LPC
- Disability insurance
- Health insurance
Quick Apply
Supplemental Patient Access Representative - Northeast (Varied Hours)
Memorial Hermann Health System —Humble, TX
- Part-time
- Mid-level
- High school diploma or GED
- Typing
4d
Patient Access Representative I: PBX Operator/Front Desk (PRN)
Memorial Hermann Health System —Houston, TX
- Full-time
- Hospital
- High school diploma or GED
- Typing
4d
Admissions Representative
Pediatric Home Service —Houston, TX
- Online Application
- Children
- Pediatrics
- Communication skills
- Disability insurance
- Health insurance
Quick Apply
Patient Access Representative I/II - Neurosurgery
UTHealth Houston —Houston, TX
- Full-time
- Customer service
- Medical office experience
- High school diploma or GED
- Health insurance
- Employee discount
4d
SLP ASSISTANT
International Leadership of Texas —Houston, TX
- $68,500 - $74,500 a year
- Full-time
- Background check
- Residential
- US work authorization
- Health savings account
- AD&D insurance

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Referral Navigator Representative - Kelsey Seybold Clinic - Utilization Review - Remote

Optum -
Pearland, TX

Quick Apply

Job Details

Full-time
$18 - $32 an hour
9 days ago

Qualifications

High school diploma or GED
ICD-10
Medical terminology

Full Job Description

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together.

Primary Responsibilities:

Serves as a centralized care navigation and coordination resource within the Medical Management Department, supporting referral completion, home health services, durable medical equipment (DME) requests, call center operations, and continuity of care activities across Kelsey-Seybold Clinic and external providers
Performs initial review, triage, and validation of clinical and administrative documentation to ensure requests meet foundational criteria for authorization, physician review, and regulatory processing
Coordinates with physicians, clinics, facilities, home health agencies, providers, members, nurses, medical reviewers, and internal departments to facilitate timely progression of patient care requests and ensure complete communication throughout the continuum of care
Supports the organization's Closed the Loop program by monitoring and coordinating activities necessary to ensure members receive requested services and that all stakeholders involved in the patient's care remain informed of outcomes and next steps

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

High School diploma or GED from an accredited program
2+ years of experience in a managed care, utilization management, referral management, care coordination, home health, durable medical equipment (DME), case management, medical office, hospital, health plan, accountable care organization (ACO), or healthcare operations environment
Experience interacting with providers, physicians, clinical staff, healthcare facilities, members, and external vendors regarding healthcare services, authorizations, referrals, or care coordination activities
Experience utilizing electronic medical records (EMR), authorization systems, payer portals, or healthcare information systems
Proven knowledge of medical terminology, healthcare delivery systems, referral management, authorization processes, and care coordination principles
Proven knowledge of medical terminology, CPT & ICD 10 coding, and prior authorization processes

Preferred Qualifications:

Graduate from accredited medical assistant program
5+ years of managed care experience either in a physician office or hospital setting health plan, ACO, or other managed care setting
Experience in creating authorization requests or billing Medicare or private insurance companies

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $18.00 to $32.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Quick Apply

Refine Your Search

authorization representative jobs in houston, tx

Referral Navigator Representative - Kelsey Seybold Clinic - Utilization Review - Remote

Patient Access Representative II - TIRR - Katy Rehab

Senior Call Center Representative - Member Services

Supplemental Patient Access Representative - Northeast (Part - time)

Patient Access Representative - Full Time

Referral Navigator Representative - Kelsey Seybold Clinic - Utilization Review

Patient Benefits Representative

BEHAVIOR SPECIALIST - NON-BCBA

Senior Patient Services Representative - Psychiatry (Medical Center)

Patient Services Representative - Primary Care (Medical Center)

Card Dispute Representative

Patient Access Representative II (Full-time)

Patient Access Representative I/II/Sr. - Bellaire Station

EDI Representative

Outpatient Intake Coordinator

Supplemental Patient Access Representative - Northeast (Varied Hours)

Patient Access Representative I: PBX Operator/Front Desk (PRN)

Admissions Representative

Patient Access Representative I/II - Neurosurgery

SLP ASSISTANT

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