Job Description
Are you a detail-oriented healthcare professional looking for an impactful remote role? We are seeking dedicated Authorization Specialists to join a fast-paced, collaborative team! In this essential role, you will be responsible for receiving, reviewing, validating, and creating prior authorization requests across multiple Medicaid lines of business, including STAR, CHIP, STAR Kids, and STAR Health.
Working comfortably from your Texas home workspace, you will ensure requests are processed accurately and routed appropriately to support timely member access to vital healthcare services. You will conduct provider outreach, research member eligibility, build authorizations in system databases, and collaborate closely with clinical review teams, provider relations, and operational leadership. If you possess strong computer skills, proficiency in Microsoft Office, and prior experience in healthcare authorization or intake processes, this is an outstanding opportunity to grow your expertise in a supportive, team-oriented environment.
Enjoy a steady Monday through Friday daytime schedule while managing meaningful work that directly impacts community health outcomes.
salary: $18.99 - $19 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School
Responsibilities
Position Summary: Process prior authorization requests for Texas Medicaid lines of business. Research member/provider data, build authorizations, conduct provider outreach for missing information, and ensure compliance with regulatory turnaround times.
Key Responsibilities: - Receive, validate, and enter prior authorization requests into utilization management databases.
- Verify member eligibility, benefits, CPT codes, and service coverage using internal system tools.
- Perform provider outreach to obtain missing medical documentation and clarify request details.
- Route completed authorization files to clinical reviewers for determination.
- Maintain worklists and ensure compliance with strict contractual and regulatory timelines.
Requirements: - High School Diploma or GED required.
- 1–2 years of prior authorization experience in a healthcare or insurance setting.
- Proficiency with database navigation and Microsoft Office (Excel, Word, Teams, Outlook).
- strong written and verbal communication skills with high typing accuracy.
Skills
- Responsiveness
- Analytical Thinking
- Basic Software Skills
- Appointment Scheduling
Qualifications
- Years of experience: 2 years
- Experience level: Experienced
Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).
This posting is open for thirty (30) days.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Job Tags
Hourly pay, Permanent employment, Temporary work, Work experience placement, Work at office, Remote work, Shift work