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TEKsystems ยท 2 days ago
Insurance Analyst
Chicago, IL
Full-time
Onsite
Entry Level
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Responsibilities
Provide subject matter expertise on medical and prescription insurance coverage/verification, claim billing, medication prior authorization, and 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.
Meet or exceed department standards relative to performance metrics. Take responsibility and accountability for the day-to-day execution of tasks and is responsible for providing periodic progress reports on goals and metrics. Work cross-functionally to identify and share opportunities for process and productivity improvement and to troubleshoot and/or resolve situations taking ownership as needed.
Decide whether to reinvestigate or accept obtained benefit verification based on reasonableness and accuracy. Determine whether to escalate issues/concerns to management for review, guidance, and resolution. Participate in quality monitoring and in identifying and reporting quality issues.
Enter patient demographic and health insurance information into the hub information system and notify the physician of any incomplete or incorrect insurance information
Understand and comply with all required training including adherence to federal, state, and local pharmacy laws, HIPAA policies and guidelines, and the policies and procedures of Pharmacy Solutions
Qualification
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Required
Insurance Verification
Prior Authorization
Grievance and Appeals
Insurance Analyst
High School Diploma
No time off within first 90 days
Company
TEKsystems
At TEKsystems, they understand people. Every year they deploy over 80,000 IT professionals at 6,000 client sites across North America,
Founded in 1994
10,001+ employees
H1B Sponsorship
TEKsystems has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Trends of Total Sponsorships
2023 (16)
2022 (23)
2021 (45)
2020 (48)
Funding
Current Stage
Late StageLeadership Team
Ryan Skains
Vice President Global Alliances
Recent News
2024-05-24
Company data provided by crunchbase
