Remote Insurance Verification & Authorization Specialist

TEKsystems; Chicago (IL); Remote; USD 23.000 - 32.000; Vollzeit

Benefits dieser Stelle

Medical, dental & vision

401(k) retirement plan

Life Insurance

PTO / Vacation / Sick Leave

Zusammenfassung

TEKsystems is seeking an Insurance Analyst I to provide best-in-class customer service to patients and HCPs by investigating insurance benefits and financial assistance opportunities, and by processing and monitoring prior authorizations to support therapy initiation and continuation.

The role requires expertise in insurance billing, claims processing, and prior authorizations, acting as a liaison among departments, payors, and providers to determine overall prescription coverage.

Qualifikationen

• 1-3 years of work experience in a healthcare or reimbursement setting.
• Previous experience in a call center environment, healthcare office, corporate setting, or healthcare insurance provider or pharmacy is required.
• Thorough understanding of commercial and government pharmacy/medical insurance programs, billing, alternate funding resources, reimbursement processes, insurance verification, prior authorizations and appeal filings, and specialty pharmacy operations.

Aufgaben

• Provide subject matter expertise on medical and prescription insurance coverage/verification, claim billing, prior authorization, and appeal filing.
• Communicate status of referrals to physicians and patients via phone, fax, and core pharmacy system.
• Assist offices through documentation and filing for prior authorizations and appeals; monitor status for rapid turnaround.
• Use internal and web tools to collaborate with health insurance payors and providers to investigate benefits and maintain payor intelligence resources.
• Enter patient demographic and health insurance information into the hub system and notify physicians of incomplete insurance data.

Kenntnisse

Pharmacy call center

Healthcare call center

Medical claims

Jobbeschreibung

TEKsystems is seeking an Insurance Analyst I to provide best-in-class customer service to patients and HCPs by investigating insurance benefits and financial assistance opportunities, and by processing and monitoring prior authorizations to support therapy initiation and continuation.

The role requires expertise in insurance billing, claims processing, and prior authorizations, acting as a liaison among departments, payors, and providers to determine overall prescription coverage.