TEKsystems
San Antonio TX - Medical Insurance Authorization Specialist - ONSITE
TEKsystems, San Antonio, Texas, United States, 78208
Responsibilities
Reviews, processes and audits the medical necessity for each patient chemotherapy treatment and documents the regimen relative to pathway adherence.
Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with particular insurance plans, and provides prompt feedback to physicians and management regarding pathway documentation issues and payer problems with non‑covered chemotherapy drugs.
Updates coding and payer guidelines for clinical staff; tracks pathways and performs various other business office functions on an as‑needed basis.
Obtains insurance authorization and pre‑certification specifically for chemotherapy services; acts as a patient advocate and liaison between the patient and payer to answer reimbursement questions and avoid insurance delays.
Researches additional or alternative resources for non‑covered chemotherapy services to prevent payment denials; provides a contact list for patients with community resources, special programs, drugs, pharmaceutical supplies, and financial resources.
Maintains a good working knowledge of chemotherapy authorization requirements for all payers, state and federal regulatory guidelines for coverage and authorization, and adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regard to patient records.
Performs other duties as requested or assigned.
Skills & Qualifications
Medical Insurance Authorization
Insurance Authorization
Clinical Review
Industry Knowledge
Radiation
Radiology
Technical Expertise: Recognized as an expert, maintains current industry knowledge, and leverages other experts when needed.
Adaptability: Confidently manages daily challenges, adjusts to shifting priorities and rapid change, remains resilient and flexible.
Sound Judgment: Makes timely, cost‑effective decisions even under uncertainty.
Work Commitment: Sets high performance standards and pursues goals efficiently.
Quality Focus: Delivers quality products/services, defines and measures standards, manages and improves processes.
Job Details Intermediate Level – Contract to Hire position based out of San Antonio, TX.
Pay $20.00 – $21.00/hr
Benefits (temporary role – eligibility may vary)
Medical, dental & vision
Critical Illness, Accident, and Hospital
401(k) Retirement Plan – Pre‑tax and Roth post‑tax contributions available
Life Insurance (Voluntary Life & AD&D for the employee and dependents)
Short and long‑term disability
Health Spending Account (HSA)
Transportation benefits
Employee Assistance Program
Time Off/Leave (PTO, Vacation or Sick Leave)
Application Deadline: anticipated to close on November 29, 2025.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
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Reviews, processes and audits the medical necessity for each patient chemotherapy treatment and documents the regimen relative to pathway adherence.
Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with particular insurance plans, and provides prompt feedback to physicians and management regarding pathway documentation issues and payer problems with non‑covered chemotherapy drugs.
Updates coding and payer guidelines for clinical staff; tracks pathways and performs various other business office functions on an as‑needed basis.
Obtains insurance authorization and pre‑certification specifically for chemotherapy services; acts as a patient advocate and liaison between the patient and payer to answer reimbursement questions and avoid insurance delays.
Researches additional or alternative resources for non‑covered chemotherapy services to prevent payment denials; provides a contact list for patients with community resources, special programs, drugs, pharmaceutical supplies, and financial resources.
Maintains a good working knowledge of chemotherapy authorization requirements for all payers, state and federal regulatory guidelines for coverage and authorization, and adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regard to patient records.
Performs other duties as requested or assigned.
Skills & Qualifications
Medical Insurance Authorization
Insurance Authorization
Clinical Review
Industry Knowledge
Radiation
Radiology
Technical Expertise: Recognized as an expert, maintains current industry knowledge, and leverages other experts when needed.
Adaptability: Confidently manages daily challenges, adjusts to shifting priorities and rapid change, remains resilient and flexible.
Sound Judgment: Makes timely, cost‑effective decisions even under uncertainty.
Work Commitment: Sets high performance standards and pursues goals efficiently.
Quality Focus: Delivers quality products/services, defines and measures standards, manages and improves processes.
Job Details Intermediate Level – Contract to Hire position based out of San Antonio, TX.
Pay $20.00 – $21.00/hr
Benefits (temporary role – eligibility may vary)
Medical, dental & vision
Critical Illness, Accident, and Hospital
401(k) Retirement Plan – Pre‑tax and Roth post‑tax contributions available
Life Insurance (Voluntary Life & AD&D for the employee and dependents)
Short and long‑term disability
Health Spending Account (HSA)
Transportation benefits
Employee Assistance Program
Time Off/Leave (PTO, Vacation or Sick Leave)
Application Deadline: anticipated to close on November 29, 2025.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
#J-18808-Ljbffr