TEKsystems
San Antonio TX - Medical Insurance Authorization Specialist - ONSITE
TEKsystems, San Antonio, Texas, United States, 78208
San Antonio TX - Medical Insurance Authorization Specialist - ONSITE
Contract to Hire position based out of San Antonio, TX. Fully on‑site.
Responsibilities
Review, process and audit the medical necessity for each patient’s chemotherapy treatment and the documentation of regimen relative to pathway adherence.
Communicate with nursing and medical staff to inform them of any restrictions or special requirements in accordance with particular insurance plans.
Provide prompt feedback to physicians and management regarding pathway documentation issues, and payer issues with non‑covered chemotherapy drugs.
Update coding/payer guidelines for clinical staff and track pathways while performing various business office functions as needed.
Obtain insurance authorization and pre‑certification specifically for chemotherapy services.
Act as a patient advocate and liaison between the patient and payer to answer reimbursement questions and avoid insurance delays.
Research additional or alternative resources for non‑covered chemotherapy services to prevent payment denials.
Provide a contact list for patients’ community resources including special programs, drugs, pharmaceutical supplies, and financial resources.
Maintain a good working knowledge of chemotherapy authorization requirements for all payers, state and federal regulatory guidelines for coverage and authorization.
Adhere to confidentiality, state, federal, and HIPAA laws and guidelines with regards to patients’ records.
Perform other duties as requested or assigned.
Skills
Medical Insurance Authorization
Insurance Authorization
Clinical Review
Industry knowledge
Radiation
Radiology
Additional Skills & Qualifications
Maintain current industry knowledge; recognized as an expert; leverage other experts when needed.
Adaptability: confidently manage daily challenges; adjust to shifting priorities and rapid change; remain resilient and flexible.
Sound Judgment: make timely, cost‑effective decisions, even under uncertainty.
Work Commitment: set high performance standards; pursue goals efficiently.
Quality Focus: deliver quality products/services; define and measure standards; manage and improve processes.
Experience Level Intermediate Level
Pay and Benefits Pay Range: $20.00 - $21.00/hr. Eligibility requirements apply to some benefits and may depend on job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms.
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 Position anticipated to close on Nov 29, 2025.
About TEKsystems 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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Responsibilities
Review, process and audit the medical necessity for each patient’s chemotherapy treatment and the documentation of regimen relative to pathway adherence.
Communicate with nursing and medical staff to inform them of any restrictions or special requirements in accordance with particular insurance plans.
Provide prompt feedback to physicians and management regarding pathway documentation issues, and payer issues with non‑covered chemotherapy drugs.
Update coding/payer guidelines for clinical staff and track pathways while performing various business office functions as needed.
Obtain insurance authorization and pre‑certification specifically for chemotherapy services.
Act as a patient advocate and liaison between the patient and payer to answer reimbursement questions and avoid insurance delays.
Research additional or alternative resources for non‑covered chemotherapy services to prevent payment denials.
Provide a contact list for patients’ community resources including special programs, drugs, pharmaceutical supplies, and financial resources.
Maintain a good working knowledge of chemotherapy authorization requirements for all payers, state and federal regulatory guidelines for coverage and authorization.
Adhere to confidentiality, state, federal, and HIPAA laws and guidelines with regards to patients’ records.
Perform other duties as requested or assigned.
Skills
Medical Insurance Authorization
Insurance Authorization
Clinical Review
Industry knowledge
Radiation
Radiology
Additional Skills & Qualifications
Maintain current industry knowledge; recognized as an expert; leverage other experts when needed.
Adaptability: confidently manage daily challenges; adjust to shifting priorities and rapid change; remain resilient and flexible.
Sound Judgment: make timely, cost‑effective decisions, even under uncertainty.
Work Commitment: set high performance standards; pursue goals efficiently.
Quality Focus: deliver quality products/services; define and measure standards; manage and improve processes.
Experience Level Intermediate Level
Pay and Benefits Pay Range: $20.00 - $21.00/hr. Eligibility requirements apply to some benefits and may depend on job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms.
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 Position anticipated to close on Nov 29, 2025.
About TEKsystems 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