Remote Insurance Verification

About the role

We are seeking an Insurance Verifier to serve as a trusted resource for patients, healthcare providers, and payer organizations. In this role, you will use your knowledge of insurance verification, prior authorizations, reimbursement processes, and financial assistance programs to help patients gain timely access to critical therapies.

Responsibilities

• Investigating and verifying medical and pharmacy insurance benefits, reimbursement options, and financial assistance programs.
• Processing, monitoring, and managing prior authorizations and appeals to help patients initiate or continue therapy without interruption.
• Communicating with patients, healthcare providers, insurance carriers, and internal teams to ensure accurate and timely resolution of coverage issues.
• Reviewing insurance information, identifying discrepancies, and documenting findings in multiple systems.
• Researching pharmacy and medical benefits using payer portals, internal resources, and direct communication with insurance companies.
• Providing regular status updates to providers and patients via phone, fax, and electronic systems.
• Supporting quality initiatives by identifying issues, participating in audits, and ensuring compliance with established procedures.
• Maintaining accurate patient demographic and insurance information while safeguarding sensitive data.
• Ensuring compliance with HIPAA regulations, pharmacy laws, and organizational policies.
• Collaborating with cross-functional teams to improve processes and enhance the patient experience.

Requirements

• A high school diploma or GED required; an associate's or bachelor's degree preferred.
• 3-4 years of experience in a healthcare reimbursement, insurance verification, or prior authorizations field.
• 3-4 years of healthcare call center experience.
• Knowledge of commercial and government insurance plans, medical and pharmacy benefits, reimbursement processes, insurance verification, prior authorizations, appeals, and specialty pharmacy operations.
• Strong problem-solving, organizational, and multitasking abilities.
• Excellent verbal and written communication skills.
• Detail-oriented with a commitment to accuracy and quality.
• Proficiency with Microsoft Office applications and the ability to learn new systems quickly.
• Ability to work independently while maintaining productivity and quality standards.
• Access to a secure, private workspace for remote work.

Preferred Background

• Experience in one or more of the following areas: Insurance Verification, Prior Authorization Processing, Pharmacy Benefits Investigation, Medical Billing and Claims, Specialty Pharmacy Operations, Healthcare Customer Service, Reimbursement Support, Financial Assistance Programs.

Benefits

• The pay range for this position is $16.00 - $20.00/hr.
• 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).

About TEKsystems

We are 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. 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.