Prior Authorization Specialist
: Job Details :

TEKsystems is looking to hire several Insurance Authorization Specialists for a large healthcare company out of San Antonio, TX!**if you have 2+ years working with insurance verification, prior authorization and referrals, please send your most updated resume to rsison @ teksystems.com - these resumes will be reviewed first and interviews are first come, first serve. - please only submit your resume if you have the experience applicable to the job posting!**Description· Reviews, processes and audits the medical necessity for each patient chemotherapy treatment and documentation of regimen relative to pathway adherence.· Understanding the difference between a referral and authorization· Obtains insurance authorization and pre-certification specifically for chemotherapy services.· Works as a patient advocate and functions as a liaison between the patient and payer to answer reimbursement questions and avoid insurance delays.· Able to differentiate Health Plans (HMO vs PPO) and the Health Plan Requirements· Provides a contact list for patients community resources including special programs, drugs and 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.Must be familiar with these insurance payers accepted by Texas Oncology: Skills & Qualifications· Authorization experience is a plus, preferably in Oncology· Associates degree in Healthcare, LPN state license and registration preferred· Radiology authorization experiencePay and BenefitsThe pay range for this position is $20.00 - $20.00- 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 TypeThis is a fully onsite position in San Antonio,TX.Application DeadlineThis position will be accepting applications until Jan 1, 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 regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.