TEKsystems je globalno podjetje za tehnološko svetovanje in rešitve za delovno silo, ki nudi storitve organizacijam s področja gospodarstva. Njegovo delo zajema oblačne tehnologije, podatke in umetno inteligenco, avtomatizacijo, razvoj aplikacij, preobrazbo na področju agilnih metod in DevOps, tehnološke operacije ter digitalno uporabniško izkušnjo. Podjetje zagotavlja tudi storitve pridobivanja talentov, zaposlovanja in upravljanih storitev ter podpira tehnološke ekipe in obsežne programe za delovno silo v sektorjih, kot so finančne storitve, zdravstvo, javni sektor, telekomunikacije, maloprodaja, proizvodnja in energetika. Njegov širok model storitev ustvarja priložnosti na področjih svetovanja, inženirstva, tehnoloških operacij in zaposlovanja.
Remote Insurance Verification Call Center Representative
Verify health and prescription coverage, process prior authorizations and appeals, and help patients access medications. The role supports patients and provider offices through TEKsystems’ healthcare services.
Opis
- Verify patients’ medical and prescription insurance coverage and benefits
- Process and track prior authorizations and appeals to help patients access medication
- Share referral and authorization updates with patients, providers, and insurers by phone, fax, and electronic systems
- Guide provider offices through prior authorization and appeal submissions
- Work with insurers, healthcare providers, and internal teams to confirm coverage details
- Record communications and insurance information accurately in company systems
- Find and explain alternative funding and financial assistance options for patients
- Check benefit verification details for accuracy and identify cases requiring further review
- Refer complex issues to management when needed
- Follow HIPAA, federal and state regulations, and company policies
- Add and update patient demographic and insurance records
- Recognize and report potential adverse events under FDA and company guidelines
- Achieve quality, productivity, and performance targets
- Take part in ongoing training, process improvement, and assigned special projects
Zahteve
- Bring 13 years of experience in healthcare, insurance, reimbursement, pharmacy, or customer service
- Have prior experience in a call center, healthcare office, insurance provider, pharmacy, or corporate environment
- Demonstrate strong customer service and communication abilities
- Manage multiple tasks while maintaining accuracy and attention to detail
- Use Microsoft Office proficiently and learn new software systems quickly
- Apply strong problem-solving and organizational skills
- Have access to a secure, private workspace
- Pharmacy call center experience is preferred
- Healthcare call center experience is preferred
- Medical claims processing experience is preferred
- Insurance verification experience is preferred
- Knowledge of commercial and government insurance programs is preferred
- Understanding of prior authorizations, appeals, reimbursement, and specialty pharmacy operations is preferred
Ugodnosti
- Medical, dental, and vision coverage
- Critical illness, accident, and hospital coverage
- 401(k) retirement plan with pre-tax and Roth after-tax contributions
- Voluntary life and AD&D insurance for employees and dependents
- Short- and long-term disability coverage
- Health Savings Account (HSA)
- Transportation benefits
- Employee Assistance Program
- Paid time off, vacation, or sick leave