TEKsystems · 11 hours ago
Pharmacy Benefits Verification Manager
United States
Full-time
Remote
Entry, Mid Level
$21/hr - $21/hr
2+ years expTEKsystems is a leading provider of business and technology services, seeking a Pharmacy Benefits Verification Manager. This remote role involves conducting high-volume outbound calls to payors and pharmacy benefit managers to verify copay eligibility for commercially insured patients, with a strong focus on documentation and compliance.
Information Technology
Responsibilities
Make outbound PBM/payor calls for copay eligibility throughout the workday; maintain phone engagement up to 95% of the shift while executing the correct outbound campaigns and dispositions
Follow approved Call Guides to ask structured, plan‑identifying questions of PBM agents; use compliant script/verbiage and payor‑call steps
Determine and record the verified plan type: Traditional, Accumulator, Hybrid Accumulator, Maximizer, or Hybrid Maximizer, etc. using program definitions and SOPs
Use PBM‑specific prompts (e.g., BIN/PCN/Group workflows, NPI handling, maximizer screening questions) to obtain the benefit details needed for eligibility determination
Document every interaction accurately and in real time: complete call‑guide fields, outcomes, and notes in the designated CRM/telephony tools before taking/making the next call
Create and manage follow‑up activities/tasks as needed with timely completion
Maintain availability/status discipline in the telephony platform (Available/Ready, appropriate Away Codes, correct outbound campaign selection) to maximize connect time
Adhere to program compliance and quality standards (privacy, script adherence, recorded‑call protocols) and participate in QA monitoring
Collaborate professionally with payor/PBM contacts and internal teams; route inquiries outside program scope through approved channels
Qualification
Required
High School Diploma or equivalent, some college preferred
Minimum 2 years experience in pharmacy benefits
Advanced ability/knowledge of all Microsoft Suite programs (Teams, Word, Excel, Outlook, etc) and soft phone systems (WebEx, Mitel, Shoretel, etc.)
Exceptional communication skills, both written and verbal
Able to work in a virtual team environment by being available and responsive during working hours
This is a remote position. Employees must have a private workspace free of distraction to adhere to HIPAA compliance/guidelines. Workspace must include internet plug-in accessibility. Wi-fi connectivity is not permitted
A working cell phone is required for 2 step authentication verifications during the length of the assignment
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)
Company
TEKsystems
At TEKsystems, they understand people. Every year they deploy over 80,000 IT professionals at 6,000 client sites across North America,
10001+ 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
Represents job field similar to this job
Trends of Total Sponsorships
2025 (46)
2024 (52)
2023 (33)
2022 (22)
2021 (36)
2020 (53)
Funding
Current Stage
Late StageLeadership Team
Ryan Skains
Vice President, TEKsystems Global Services
Recent News
2025-11-19
2025-10-29
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