[Hiring] Insurance/Prior Authorization Specialist @TEKsystems

Role Description

This position will be a subject matter expert in insurance billing claims processing and prior authorizations. This position liaises between departments, payors, and providers to comprehensively determine patients' overall prescription coverage.

• Provide subject matter expertise on medical and prescription insurance coverage, verification, claim billing, medication prior authorization, appeal filing, and alternate financial assistance opportunities.
• Accurately document information in the appropriate systems and formats.
• Communicate the status of the referral to the physician and the patient via phone, fax, and/or the core pharmacy system as per established policies and procedures.
• Assist offices through the entire documentation and filing process for prior authorizations and appeals.
• Monitor the status to ensure a rapid turnaround resulting in procurement of the drug product for the patient.
• Use internal and web tools and communicate and collaborate with health insurance payors and providers to investigate pharmacy and medical benefits.
• Obtain and confirm information to maintain Pharmacy Solutions payor intelligence resources.
• Enter patient demographic and health insurance information into the hub information system and notify the physician of any incomplete or incorrect insurance information.

Qualifications

• A+ Candidates will have pharmacy call center experience.
• A- Candidates will have healthcare call center and medical claims experience.
• 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.
• Must have thorough understanding and knowledge of commercial and government pharmacy and medical insurance programs, billing, alternate funding resources, reimbursement processes, insurance verification, prior authorization and appeal filings, and specialty pharmacy operations.

Requirements

• This is a Contract position based out of Minneapolis, MN.
• The pay range for this position is $20.00 - $20.00/hr.
• Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Benefits

• 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)

Application Deadline

This position is anticipated to close on Oct 17, 2026.

Workplace Type

This is a fully remote position.