Date Posted: 08/26/2026
Hiring Organization: Rose International
Position Number: 506304
Industry: Pharmaceutical/Healthcare
Job Title: Prior Authorization & Insurance Verification Specialist
Job Location: Plano, TX, USA, 75024
Work Model: Onsite
Shift: Monday-Friday, 8:00 AM-5:00 PM
Employment Type: Temporary
FT/PT: Full-Time
Estimated Duration (In months): 6
Min Hourly Rate($): 20.00
Max Hourly Rate($): 21.00
Must Have Skills/Attributes: Authorization, Billing, Documentation, Health Insurance, Insurance
Experience Desired: Prior Authorization & Utilization Review (2+ yrs); Healthcare Insurance & Medical Coding (2+ yrs); Medical Billing & Documentation (1+ yrs)
Required Minimum Education: Associate’s Degree
**C2C is not available**
Job Description
Required Education:
• Associate degree in Nursing/Home Health (LVN/LPN) or related field required
Required Experience
• Minimum of 2 plus yrs experience in a utilization (medical approval) environment or similar work experience
Preferred Experience
• Knowledge of private insurance, Worker’s Compensation and Medicare guidelines pertaining to Prospective and Retrospective Utilization Review.
• Experience in medical device or DME Billing a plus
• Proficient with Microsoft Office (Word & Excel specifically)
• Medical billing software experience a plus
• Knowledge of current CPT codes and familiarity with ICD-10CM (diagnosis coding)
• Ability to accurately meet required time frames/deadlines
• Ability to work as a team player and share workloads with other team members
• Excellent verbal and written communication skills
• Ability to train/present concepts to others
Overview (Prior Authorization Specialist)
Prior Authorization Specialist responsible for managing multiple medical authorization cases, verifying insurance benefits, obtaining procedure approvals, and coordinating required clinical documentation with insurance carriers and healthcare providers. The role also handles appeals for denied requests, authorization follow-ups, provider education, and case tracking while ensuring compliance with company policies and privacy requirements.
Responsibilities
• Assist with multiple levels of appeal in the event of initial coverage denial
• Forward authorized confirmation for procedure to designated patient provider. In addition, this position will provide in-servicing to new patient providers surrounding the pre-authorization process
• Responsible for managing multiple cases simultaneously within specific time frames
• Follow all policies and procedures related to performing the job role adhering to all data use, storage and privacy policies as outlined by Client
• Verify benefits, complete authorization requests promptly
• Timely follow up for requested authorizations
• For each procedure, audit required clinical documents for completeness and accuracy
• Obtain authorization for the facility, equipment and physician to perform various procedures from the insurance carrier
• Work with key provider contacts to obtain required clinical information for authorizations
• Work with respective carrier’s utilization review department to obtain appropriate authorizations
• Work within established guidelines when necessary to process appeal for denied requests
• Train patients and their designated providers on pre-authorization processes and requirements, in person or by phone
• Work individually and in a team environment to educate assigned Field Territory Managers and Clinical Specialists - **Only those lawfully authorized to work in the designated country associated with the position will be considered.**
- **Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client’s business needs and requirements.**
Benefits:
For information and details on employment benefits offered with this position, please visit here. Should you have any questions/concerns, please contact our HR Department via our secure website.
California Pay Equity:
For information and details on pay equity laws in California, please visit the State of California Department of Industrial Relations' website here.
Rose International is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender (expression or identity), national origin, arrest and conviction records, disability, veteran status or any other characteristic protected by law. Positions located in San Francisco and Los Angeles, California will be administered in accordance with their respective Fair Chance Ordinances.
If you need assistance in completing this application, or during any phase of the application, interview, hiring, or employment process, whether due to a disability or otherwise, please contact our HR Department.
Rose International has an official agreement (ID #132522), effective June 30, 2008, with the U.S. Department of Homeland Security, U.S. Citizenship and Immigration Services, Employment Verification Program (E-Verify). (Posting required by OCGA 13/10-91.).
It is a great pleasure being a part of the Rose International Team.
Toni, Consultant
The interactions that I have had with your representatives have always been prompt and very professional. I am very pleased and impressed with your company and services.
Sioe, Consultant
Your team at Rose International is always very helpful and responsive.
Barbara, Consultant
Thanks for the opportunity. If in the future I ever need a job, I would like to work for Rose International.
David, Consultant
I believe the best thing that Rose HR has going for it is the incredible responsiveness. Everyone is very quick to reply to any concerns, and contacts the contracted employees very quickly and efficiently.
Kevin, Consultant
EMPLOYEE COMMENTS