Insurance Verification Specialist

Are you passionate about supporting patients and ensuring their healthcare needs are met? We have an exciting opportunity for you!

TEKsystems is actively hiring candidates with experience in both insurance verification and prior authorization.

To be considered for this role, candidates must demonstrate the ability to initiate and manage the predetermination process. Ideal applicants will have hands-on experience working directly with insurance companies to obtain authorizations for outpatient visits and procedures. We are specifically seeking individuals who have worked closely with payers to secure authorizations before services are rendered.

Key Responsibilities:

• Contact insurance companies to verify benefits and obtain pre-certification for both surgical and non-surgical procedures.
• Notify the financial counselor regarding prepayment requirements for uncoded services.
• Provide all necessary documentation to insurance companies during the pre-certification process.
• Maintain the daily surgery/procedure schedule for department faculty and ensure open communication with physicians and their assistants.
• Keep a detailed log of all ongoing pre-certifications and inform the hospital’s utilization/billing department accordingly.
• Ensure all documentation is properly received and recorded once pre-certification is obtained.

Required Skills:

• Proven experience in insurance verification and prior authorization.
• Strong understanding of pre-qualification and predetermination processes.
• Excellent communication and organizational skills.
• Ability to manage multiple tasks and maintain accurate records in a fast-paced environment.