Insurance Verification Specialist

TEKsystems • Berwyn, IL

6d • $20 - $20 • Remote

About The Position

We are seeking an Insurance Analyst I to support patients and healthcare providers with insurance benefits, claims, prior authorizations, and reimbursement needs. The role is suited to someone with healthcare call center, medical insurance, pharmacy, or claims experience who is comfortable communicating directly with insurance payers and healthcare providers.

The work primarily involves outbound calls to insurance payers to obtain claim and authorization status, documenting updates, and creating cases to keep patients and providers informed. The specialist works with internal teams, insurance companies, and healthcare providers to help patients access and continue prescribed therapies. This is a fully remote contract position based out of Chicago, IL, with scheduled eight-hour shifts between 7 a.m. and 7 p.m., Monday through Friday.

Requirements

• 13 years of experience in a healthcare or reimbursement-related environment.
• Previous experience in one or more of the following: healthcare call center, medical claims or reimbursement, health insurance, pharmacy or specialty pharmacy, or healthcare/medical office.
• Knowledge of medical and pharmacy insurance, insurance verification, claims processing, billing, prior authorizations, and appeals.
• Understanding of commercial and/or government insurance programs.
• Strong attention to detail and ability to accurately document patient and insurance information.
• Ability to manage multiple priorities and meet deadlines in a high-volume environment.
• Strong written and verbal communication skills.
• Comfort making frequent outbound calls to insurance payers.
• Proficiency with Microsoft Office and ability to quickly learn new computer systems.

Responsibilities

• Verify medical and prescription insurance coverage and benefits.
• Make outbound calls to insurance payers to obtain claim, coverage, and authorization status.
• Research and troubleshoot insurance billing, claims, reimbursement, and coverage issues.
• Assist healthcare provider offices throughout the prior authorization and appeals process.
• Monitor prior authorizations and appeals to help ensure timely resolution.
• Communicate referral and case status updates to patients and healthcare providers via phone, fax, and internal systems.
• Enter and maintain accurate patient demographic and insurance information.
• Research commercial and government insurance benefits and identify potential financial assistance opportunities.
• Document all interactions and case updates accurately and thoroughly.
• Manage multiple cases and priorities while meeting established productivity and quality expectations.
• Follow applicable HIPAA, privacy, compliance, and healthcare regulations.
• Identify and appropriately report potential adverse events according to established procedures.

Benefits

• If eligible, benefits for this temporary role may include medical, dental, and vision coverage; critical illness, accident, and hospital coverage; a 401(k) retirement plan with pre-tax and Roth post-tax contributions; voluntary life and AD&D insurance for the employee and dependents; short- and long-term disability; a Health Spending Account (HSA); transportation benefits; an Employee Assistance Program; and time off/leave, including PTO, vacation, or sick leave. Eligibility may depend on job classification and length of employment, and benefits are subject to change and applicable plan terms.

What This Job Offers

• Education Level: No Education Listed