Benefits Verification Specialist

About the role

This role manages communications with healthcare providers, physician offices, specialty pharmacies, and health insurance plans regarding patient insurance benefits and coverage details. The position involves verifying insurance benefits, conducting outreach, coordinating prior authorizations, and maintaining compliance with HIPAA regulations.

Responsibilities

• Manage inbound and outbound communications with healthcare providers, physician offices, specialty pharmacies, and health insurance plans regarding patient insurance benefits and coverage details.
• Verify patients' medical and pharmacy insurance benefits, including eligibility, coverage limitations, copayments, deductibles, coinsurance, and out-of-pocket responsibilities.
• Conduct outreach to providers, insurance carriers, and other stakeholders to obtain required documentation, benefit verifications, and prior authorizations.
• Review patient cases and accurately assess insurance requirements, identifying any additional actions needed to facilitate access to treatment or services.
• Coordinate and track prior authorizations, appeals, referrals, and other reimbursement-related activities to ensure timely resolution.
• Document all interactions, benefit information, authorization statuses, and case updates in the appropriate systems.
• Identify coverage gaps, insurance denials, or reimbursement barriers and escalate issues as necessary.
• Schedule or coordinate follow-up activities, including provider outreach, patient communication, and appointment-related insurance requirements.
• Maintain compliance with HIPAA regulations and company policies when handling protected health information.

Requirements

• HS Diploma/GED Equivalent
• 2+ years of healthcare call center experience
• 2+ years experience with insurance verification

Skills

• Health insurance
• Customer service
• Health care
• Call center
• patient access
• benefits verification

Additional Skills & Qualifications

• Healthcare knowledge
• Communication skills
• Problem-solving abilities

Benefits

Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• 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)

Job Type & Location

This is a Contract position based out of Tampa, FL.

Pay and Benefits

The pay range for this position is $23.00 - $23.00/hr.

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.

About TEKsystems Global Services

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies.

San Francisco Fair Chance Ordinance

Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.