TEKsystems
The Prior Authorization Specialist is responsible for obtaining and verifying prior authorizations for medical services, procedures, and medications to ensure compliance with payer requirements and prevent claim denials. This role requires strong attention to detail, knowledge of insurance guidelines, and effective communication with providers, patients, and insurance companies.
Key Responsibilities
Review provider orders and clinical documentation to determine prior authorization requirements.
Submit authorization requests to insurance carriers via portals, fax, or phone.
Track and follow up on pending authorizations to ensure timely approval.
Communicate authorization status to providers, scheduling teams, and patients.
Document all authorization activities in the electronic health record (EHR) and billing system.
Resolve authorization-related denials and resubmit requests as needed.
Maintain up-to-date knowledge of payer policies and authorization requirements.
Collaborate with clinical staff to obtain additional documentation when required.
Ensure compliance with HIPAA and organizational standards.
Experience Level Intermediate Level
Job Type & Location This is a Contract to Hire position based out of Fresno, CA.
Pay and Benefits The pay range for this position is $21.00 - $22.00/hr.
Eligibility requirements apply to some benefits and may depend on your 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)
Workplace Type This is a fully onsite position in Fresno, CA.
Application Deadline This position is anticipated to close on Dec 31, 2025.
About TEKsystems We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full‑Stack Technology Services, Talent Services, and real‑world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
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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Key Responsibilities
Review provider orders and clinical documentation to determine prior authorization requirements.
Submit authorization requests to insurance carriers via portals, fax, or phone.
Track and follow up on pending authorizations to ensure timely approval.
Communicate authorization status to providers, scheduling teams, and patients.
Document all authorization activities in the electronic health record (EHR) and billing system.
Resolve authorization-related denials and resubmit requests as needed.
Maintain up-to-date knowledge of payer policies and authorization requirements.
Collaborate with clinical staff to obtain additional documentation when required.
Ensure compliance with HIPAA and organizational standards.
Experience Level Intermediate Level
Job Type & Location This is a Contract to Hire position based out of Fresno, CA.
Pay and Benefits The pay range for this position is $21.00 - $22.00/hr.
Eligibility requirements apply to some benefits and may depend on your 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)
Workplace Type This is a fully onsite position in Fresno, CA.
Application Deadline This position is anticipated to close on Dec 31, 2025.
About TEKsystems We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full‑Stack Technology Services, Talent Services, and real‑world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
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