Insurance Analyst I

TEKsystems•North Chicago, IL

2d•$20 - $20•Remote

About The Position

We are seeking a detail-oriented and customer-focused Insurance Analyst I to join a growing healthcare support team. In this role, you will help patients gain access to critical therapies by investigating insurance benefits, coordinating prior authorizations, supporting appeals, and identifying financial assistance options. The ideal candidate has experience in healthcare, insurance verification, pharmacy operations, medical claims, or a call center environment and enjoys solving complex coverage issues while providing exceptional support to patients, providers, and insurance companies. This is an excellent opportunity for professionals looking to expand their careers within healthcare reimbursement, specialty pharmacy, and insurance operations.

Requirements

1-3 years of experience in healthcare, pharmacy, insurance, reimbursement support, or medical administration.
Previous experience in a healthcare call center, medical office, pharmacy, insurance company, or related environment.
Knowledge of insurance verification, prior authorizations, appeals, medical claims, or reimbursement processes.
Strong customer service and communication skills.
Ability to manage multiple priorities while maintaining accuracy and attention to detail.
Proficiency with Microsoft Office and multiple computer systems.
Ability to work independently in a remote environment with a secure and private workspace.

Nice To Haves

Specialty pharmacy experience.
Pharmacy call center experience.
Healthcare insurance or medical claims processing experience.
Knowledge of commercial, Medicare, and Medicaid plans.
Experience supporting prior authorizations and appeals.
Familiarity with reimbursement assistance programs and specialty medication access.

Responsibilities

Verify medical and prescription insurance benefits and coverage eligibility.
Research and interpret commercial, Medicare, Medicaid, and other insurance plans.
Investigate coverage determinations, reimbursement requirements, and patient out-of-pocket responsibilities.
Maintain accurate documentation of insurance information and benefit verification results.
Assist providers throughout the prior authorization and appeals process.
Gather and review required clinical and insurance documentation.
Track authorization requests and follow up with payers to ensure timely decisions.
Communicate status updates to providers and patients throughout the approval process.
Serve as a primary point of contact for patients, healthcare providers, insurance carriers, and internal teams.
Handle inbound and outbound phone calls, electronic referrals, and fax communications.
Answer questions regarding insurance coverage, claim status, authorization requirements, and financial assistance programs.
Deliver compassionate, professional customer service while managing sensitive healthcare information.
Research claim issues and reimbursement challenges.
Collaborate with payers and providers to resolve coverage barriers.
Identify alternative funding resources and patient assistance opportunities.
Support patients in accessing prescribed therapies as quickly as possible.
Accurately enter patient demographics, insurance information, and case updates into company systems.
Maintain HIPAA compliance and protect confidential patient information.
Participate in quality assurance activities and identify opportunities for process improvements.
Escalate reimbursement, authorization, or coverage concerns when appropriate.