Remote Insurance Verification

TEKsystems•Houston, TX

3d•$16 - $20•Remote

About The Position

Insurance Verification – Remote Healthcare Reimbursement Specialist Location: 100% Remote Employment Type: Full-Time, Contract to Potential Hire Make a Difference in Patient Access to Care Are you passionate about helping patients navigate complex insurance and reimbursement processes? 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. This is an excellent opportunity for professionals with healthcare, pharmacy, insurance, reimbursement, or call center experience who enjoy problem-solving, customer service, and making a meaningful impact on patient outcomes.

Requirements

High School Diploma or GED required; Associate's or Bachelor's degree preferred.
3-4 years of experience in a healthcare reimbursement, insurance verification or prior authorizations (REQUIRED)
3-4 years of healthcare call center (REQUIRED)
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.

Nice To Haves

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

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.