Authorization Specialist II - Remote, TX

Authorization Specialist II

Location: Remote, TX

Pay Rate: Starting at $19.00/hour

Schedule: Monday-Friday | 8:00 AM - 4:30 PM

Possibility of weekend shifts in the future; advance notice will be provided.

Dean's Professional Services is seeking a detail-oriented and experienced Authorization Specialist II to support a leading healthcare organization in Texas. This remote opportunity is ideal for a healthcare administrative professional with experience in prior authorizations, utilization management, insurance verification, and medical documentation.

Responsibilities

• Support the prior authorization process by researching, documenting, and maintaining accurate member and medical information.

   

• Review referrals and gather relevant medical information, including history, diagnosis, prognosis, and requested services, for clinical review.

   

• Verify member insurance coverage, eligibility, benefits, and authorization requirements using available system tools.

   

• Process and update authorization requests in the utilization management system.

   

• Ensure authorization requests are routed to the appropriate clinical reviewer and processed within contractual and regulatory timelines.

   

• Maintain accurate documentation and ongoing tracking of authorizations and referrals.

   

• Assist the utilization management team with identifying required information and resolving authorization-related issues.

   

• Evaluate member needs and assist with coordinating appropriate services, providers, specialists, and community resources.

   

• Coordinate communication between members, families or caregivers, healthcare providers, and internal care management teams.

   

• Provide information and education regarding healthcare benefits, referrals, service options, and provider instructions.

   

• Monitor member care plans and service needs and communicate recommendations to the appropriate team members.

   

• Maintain accurate member records and care management documentation in accordance with applicable policies, regulations, and payer requirements.

   

• Remain current on healthcare authorization procedures, policies, utilization management requirements, and applicable guidelines.

   

• Perform other duties and special projects as assigned.

   

Qualifications

• High School Diploma or GED required.

   

• Bachelor's degree preferred.

   

• 1-2 years of related healthcare, authorization, utilization management, insurance, or care coordination experience required.

   

• Prior authorization or medical insurance experience preferred.

   

• Knowledge of medical terminology and insurance terminology preferred.

   

• Strong data entry, documentation, and organizational skills.

   

• Ability to research information, identify missing documentation, and follow established guidelines.

   

• Excellent verbal and written communication skills.

   

• Strong attention to detail and ability to manage multiple authorization requests and deadlines.

   

• Ability to work independently and effectively in a remote environment.

   

• Strong computer skills and ability to navigate multiple healthcare systems and applications.

   

• Ability to maintain confidentiality and comply with organizational policies and regulatory requirements.

   

Why Join Dean's Professional Services?

• Competitive pay starting at $19.00/hour

   

• Comprehensive benefits package including medical, dental, vision, and 401(k)

   

• Consistent Monday-Friday remote schedule

   

• Opportunity to build valuable experience in prior authorization and utilization management

   

• Supportive, team-oriented, and healthcare-focused work environment

   

• Opportunity to develop expertise in healthcare insurance, member services, and care coordination

   

• Potential for additional scheduling opportunities as business needs evolve

   

Dean's Professional Services is a national, award-winning staffing firm. Since 1993, we have connected over 50,000 healthcare professionals with leading organizations across the country by matching exceptional talent with rewarding career opportunities.

Apply today at www.deansprofessionalservices.com or call 713-785-7483 for more information.

Healthcare Staffing | Dean's Professional Services | United States

Dean's Professional Services is a national, award-winning staffing firm providing temporary, temp-to-hire, and direct hire solutions across healthcare and professional industries.