Benefits Verification Specialist

TEKsystems • Durham, NC

5d • $21 - $21 • Remote

About The Position

We are seeking a Benefits Verification Specialist to join our team. This role involves conducting high-volume outbound calls to payors and pharmacy benefit managers (PBMs) to verify copay eligibility for commercially insured patients on supported products. The position is phone-intensive (up to 95% of the shift on calls) and requires strict adherence to approved call guides, accurate documentation, and professional customer service. Note: There is no patient or caregiver interaction in this role.

Requirements

• High School Diploma or equivalent (some college preferred).
• 1–2 years in a high-volume call center environment.
• At least 1 year in insurance verification, pharmacy benefit investigation, or related healthcare services.
• Familiarity with PBM processes and copay assistance programs.
• Strong computer proficiency (CRM systems, Microsoft Suite, telephony tools).
• Excellent verbal communication and active listening skills.
• Ability to follow SOPs and escalate issues appropriately.
• Must have a private, distraction-free workspace that meets HIPAA compliance standards (wired internet required; Wi-Fi not permitted).
• Working cell phone required for two-step authentication.
• Ability to type 30+ WPM and navigate multiple systems simultaneously.

Responsibilities

• Make outbound calls to PBMs/payors to verify copay eligibility throughout the workday.
• Maintain phone engagement for up to 95% of the shift while following approved call guides and compliant scripts.
• Identify and document plan types (e.g., Traditional, Accumulator, Maximizer) using program SOPs.
• Gather benefit details using PBM-specific workflows and prompts.
• Accurately document all interactions in CRM/telephony tools in real time.
• Create and manage follow-up tasks as needed.
• Maintain telephony platform status discipline to maximize connect time.
• Adhere to compliance and quality standards, including privacy and recorded-call protocols.
• Collaborate professionally with PBM contacts and internal teams.

Benefits

• 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)

What This Job Offers

• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees