We're looking for a detail-oriented Reimbursement Case Manager to support patients in accessing their prescribed therapies. This role involves navigating insurance processes, coordinating benefits, and ensuring timely approvals for treatment. Key responsibilities include conducting benefit investigations for medical and pharmacy coverage, facilitating prior authorizations, step edits, and appeals, communicating with payers, providers, and patients to resolve access issues, maintaining accurate records in compliance with program standards, escalating complex cases as needed, following program protocols, monitoring and reporting changes in reimbursement policies and access barriers, understanding patient health conditions relevant to the program, and upholding confidentiality and ethical standards at all times.
Required skills and experience include 2+ years of experience in reimbursement, patient services, or case management, strong knowledge of Medicare, Medicaid, VA, DoD, and commercial insurance plans, experience with pharmacy and medical benefit processes, proficiency in Salesforce and Quick Path platforms, and comfort with outbound calls to payers, providers, and patients. Prior experience in a HUB or contact center environment is a plus.
Preferred qualifications include familiarity with pharmaceutical benefit workflows, experience working with field sales or reimbursement teams, ability to handle inbound transfers and third-party consent processes, and strong communication and organizational skills.
Top skills include reimbursement and insurance verification, prior authorization and benefits coordination, case management and patient support, and Salesforce proficiency.
Pay and benefits: The pay range for this position is $20.00 - $22.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include medical, dental & vision, critical illness, accident, and hospital insurance, 401(k) retirement plan, life insurance, short and long-term disability, health spending account, transportation benefits, employee assistance program, and time off/leave.
This is a fully remote position. Application deadline is anticipated to close on Oct 31, 2025.
About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe, and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information, or any characteristic protected by law.