Care Manager

TEKsystems; Orlando (FL); Remote; USD 60,000 - 80,000; Full time

Job summary

A healthcare solutions provider is seeking a Care Manager to assist with insurance verification and patient enrollment in assistance programs. This remote role requires strong communication skills and experience in pharmacy benefits. The ideal candidate will have a high school diploma and 3 years of call center experience. A competitive pay range of $21.00/hour is offered along with comprehensive benefits.

Benefits

Medical, dental & vision

401(k) Retirement Plan

Employee Assistance Program

Time Off/Leave

Qualifications

• Minimum two years experience in pharmacy benefits, including J-code and/or HCPCS.
• Minimum 3 years of recent experience in a call center environment.

Responsibilities

• Responsible for all inbound and outbound phone calls to patients and providers.
• Assist with the prior authorizations with attention to detail.
• Provide courteous customer service to internal and external customers.

Skills

Patient communication

Insurance verification

Benefit investigation

Call center experience

Education

High School Diploma or equivalent

Job description

Position Summary

Care Manager responsibilities will vary by program and its lifecycle. Care Manager's may be responsible for contacting insurance companies to obtain correct eligibility information, perform benefit investigations, copay assistance and check prior authorization and/or appeal status. Care managers may also be responsible for directly contacting patients and/or providers to evaluate eligibility for assistance programs and/or varied adherence support. This is a remote position.

Primary Responsibilities

1. Responsible for all inbound and outbound phone calls to patients and providers.
2. Responsible for single point of contact communication with providers and patients in a designated geographical area.
3. Contact insurance companies to perform appropriate benefit investigation(s) and coverage eligibility for client product only.
4. Assist with the prior authorizations with specific attention to detail and accuracy with provided information.
5. Assist patients with the enrollment process for manufacturer and non-profit organization copay assistance programs.
6. Provide courteous, friendly, professional and efficient service to internal and external customers including physicians and patients.
7. Update job knowledge by participating in educational opportunities and training activities.
8. Work efficiently both individually and within a team to accomplish required tasks.
9. Maintain and improve quality results by adhering to standards and guidelines and recommending improved procedures.
10. Eligibility authorization and enrollment into Patient Assistance Program(s).
11. Ability to verify insurance requirements to support current billing processes.
12. Demonstrate a firm grasp of medical billing processes communicating knowledge to internal and external customers.

Required Qualifications

1. High School Diploma or equivalent, some college preferred.
2. Minimum two years experience in pharmacy benefits, must include work with J-code and/or HCPCS.
3. Minimum 3 years of recent experience in a call center environment.

Pay and Benefits

The pay range for this position is $21.00 - $21.00/hr.

• 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)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Oct 27, 2025.

EEO Statement

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.