Hybrid Surgical Benefits Verifier

TEKsystems; United States; Hybrid; USD 34,000 - 37,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

Job summary

TEKsystems is seeking a Benefits Verification Specialist to join a hybrid team supporting patients, providers, and physician offices through insurance verification, prior authorizations, and appeals for surgical procedures. You will advocate for patients by confirming coverage with commercial carriers, Medicare, and Medicaid, and collaborate with clinical staff to secure medically necessary approvals.

The role offers a Monday–Friday schedule, 8:00 AM–5:00 PM, with one day in the Minneapolis

Qualifications

• 3+ years of medical insurance verification experience.
• Experience verifying benefits in a medical setting (office, hospital, health system, or healthcare org).
• Strong knowledge of benefit verification, prior authorizations, and payer requirements.
• Familiar with commercial plans, Medicare and Medicaid, and medical claims processing.
• Strong investigation and problem-solving abilities.
• Ability to analyze complex benefit information and identify coverage solutions.

Responsibilities

• Verify insurance benefits, coverage limitations, and eligibility for surgical procedures.
• Obtain prior authorizations, pre-certifications, and referral approvals as required.
• Contact commercial carriers, Medicare, and Medicaid to confirm coverage and requirements.
• Review patient accounts and investigate complex insurance situations to determine next steps.
• Collaborate with physician offices, clinical staff, and case reviewers to obtain medical documentation supporting medical necessity.
• Assist with insurance appeals and coverage exception requests when needed.
• Educate providers, office personnel, patients, and internal teams on payer requirements and guidelines.
• Provide timely updates regarding authorization status and verification findings.
• Research discrepancies, identify missing information, and resolve insurance-related issues.
• Respond to inquiries with professionalism and empathy.
• Maintain accurate records and documentation within internal systems.
• Stay current on Medicare, Medicaid, and commercial payer requirements and trends.

Skills

Insurance verification

Prior authorizations

Medicare & Medicaid

Medical claims

Problem solving

Analytical thinking

Education

High School Diploma or equivalent

Job description

TEKsystems is seeking a Benefits Verification Specialist to join a hybrid team supporting patients, providers, and physician offices through insurance verification, prior authorizations, and appeals for surgical procedures. You will advocate for patients by confirming coverage with commercial carriers, Medicare, and Medicaid, and collaborate with clinical staff to secure medically necessary approvals.

The role offers a Monday–Friday schedule, 8:00 AM–5:00 PM, with one day in the Minneapolis