Clinical Insurance Reviewer (Remote In TX)

TEKsystems; Austin (TX); Remote; USD 60,000 - 80,000; Full time

Job summary

A healthcare services provider is seeking an expert in medical insurance verification for a fully remote position. Your responsibilities will include reviewing chemotherapy regimens, communicating with clinical staff, and maintaining coding guidelines. This role requires at least three years of experience in insurance verification. The pay range is $24.00 per hour with comprehensive benefits including medical, dental, and retirement plans.

Benefits

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

Short and long-term disability

Time Off/Leave

Qualifications

• Minimum 3 years in radiation, chemo, OR surgery insurance verification.
• Experience with coding and payer guidelines required.

Responsibilities

• Review and audit chemotherapy regimens for relevance.
• Communicate insurance requirements and resolve issues.
• Maintain up-to-date coding and payer guidelines.

Skills

Medical insurance verification

Authorization processes

Communication skills

Education

High school degree or equivalent

Associates degree in Healthcare

Job description

Overview

• Review and audit chemotherapy regimens for medical necessity and pathway adherence.
• Communicate insurance requirements to clinical staff and resolve documentation or coverage issues.
• Maintain and update coding and payer guidelines.
• Obtain authorizations and act as a liaison between patients and payers.
• Research alternative resources for non-covered services and provide community support contacts.
• Stay current on payer policies and regulatory guidelines; ensure HIPAA compliance.
• Perform other duties as assigned.

Qualifications

• High school degree or equivalent.
• Associates degree in Healthcare, LPN state license and registration preferred.
• Minimum three (1-3) years of radiation, chemo, OR surgery medical insurance verification and authorization required.
• Experience Level: Expert Level

Workplace

This is a fully remote position.

Pay and Benefits

The pay range for this position is $24.00 - $24.00/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)

Application Deadline

This position is anticipated to close on Oct 24, 2025.

About TEKsystems and equal opportunity statements have been removed to avoid boilerplate content while preserving the core job information above.