[Hiring] Insurance Verification Specialist @TEKsystems

Role Description

TekSystems is currently hiring for a Fully Remote Medical Insurance Specialist Role! This position MUST sit on the EST time zone.

MUST HAVE: 2-5 years of medical insurance verification, experience with all healthcare's, understanding of patient bills, and medical benefits. EPIC experience is a HUGE plus!

• Provides assistance to patients and providers by confirming and completing required pre-certification/authorizations prior to service to ensure a positive patient/provider experience and mitigate denials.
• Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations.
• Attends training sessions and workshops offered, including but not limited to, CRCS Training, bulletin review, etc.
• Completes annual mandatory training (SITEL) within defined time frame.
• Verifies eligibility and conformance to departmental managed care requirements and contracts. References the MedStar Managed Care Matrix and online Handbook as necessary.
• Obtains insurance referrals and pre-authorizations. Submits all referral information to necessary providers, as appropriate.
• Reviews all scheduled procedures and initiates authorization and pre-certification activities.
• Maintains ongoing communication with insurance companies to determine eligibility of benefits, deductible status, and to obtain precertification for assigned scheduled procedures.
• Ensures all relevant data is entered into the IDX application and links data to the appropriate appointment/visit.
• Monitors and completes the MedConnect Pre-Authorization Work Queue as required with accurate authorization status.
• Maintains current knowledge of regulatory and specific changes as it relates to Pre-Authorization and Pre-Certification requirements.
• Maintains daily performance benchmarks as it applies to interpreting and evaluating Pre-Authorization and Pre-Certification requirements.
• Maintains departmental Quality Assurance standards within established error rate.
• Participates in PFS or PUBS workgroups, staff meetings, and work events.
• Maintains professional, positive, and effective communication with payers, providers, and staff.
• Maintains confidentiality of all information pertaining to all of the patients reviewed.

Qualifications

• 2-5 years of healthcare insurance verification experience.
• High volume healthcare IV experience; authorizations experience is a huge plus.
• Understanding of all of the insurances and plans.
• Experience with EPIC is a HUGE plus!
• Working knowledge and demonstrated proficiency in payer authorization and clearance processes.
• Requires basic working knowledge of UB04, HCFA 1500 or equivalent and payer responses.
• Requires some knowledge of medical terminology and CPT/IDC-9 coding.
• Excellent communication, analytical, interpersonal, and organizational skills.
• Proficient use of hospital registration and/or billing systems and personal computers as well as Microsoft Excel and Word applications.
• Ability to type 35 WPM.

Requirements

• This is a Contract to Hire position based out of Baltimore, MD.

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 Nov 23, 2026.

Workplace Type

This is a fully remote position.