Prior Authorization Specialist (Healthcare) at TEKsystems

Job Title: Case Manager (Healthcare)

Location: Jeffersonville, IN (On-site)

About the Role: Are you passionate about healthcare and making a real difference in patients’ lives? We are seeking a Case Manager to provide essential support to patients, healthcare providers, and clients by navigating insurance coverage, reimbursement challenges, and healthcare access.

This role is an exciting opportunity for someone with a strong healthcare experience and a passion for patient advocacy. You will play a pivotal role in helping patients access the treatments they need while building trusted relationships with healthcare providers and client stakeholders.

Benefits & Perks

Once you land this position, you’ll get to enjoy:

• Company paid Short-term Disability (STD)

• Increased competitive 401(k) company match up to 4%

• Affordable Medical, Dental, and Vision benefits - We covers 75% of Medical Premiums

for our employees

• Concierge Medical Clinic free of cost for those enrolled in medical

plans (including dependents)

• Wellness discounts of up to $260 per year for participation in wellness program

• Annual HSA employer contribution

• Company paid and voluntary Life Insurance options

• Voluntary Life, AD&D and Long-Term Disability Insurances

• Paid Parental Leave of Absence

• Wellness and Employee Assistance Programs

• PTO benefits, flex days and paid holidays

• Employee Referral Program

• Ambassador Program

• Tuition reimbursement program up to $5,000 per year

Competitive Compensation & Flexible Working

• Competitive starting pay rates

• Toll reimbursement program (valued at $678.60 per year)

Key Responsibilities:

• Patient & Healthcare Provider Support:
• Serve as a resource for patients, prescribers, and healthcare providers to ensure smooth navigation through insurance coverage and reimbursement challenges.
  • Conduct post-benefit investigation calls and communicate coverage options to patients and physicians.
  • Provide personalized case management, including communicating benefits coverage and next steps.
  • Leverage technology to identify payer coverage, follow up with payers, and resolve outstanding issues.
• Relationship Management:
  • Build and maintain strong, trusted relationships with patients, healthcare providers, and client stakeholders through proactive communication and exceptional service.
  • Manage all interactions in compliance with healthcare regulations, including HIPAA and insurance guidelines.
• Inbound Call & Case Management:
  • Handle inbound calls based on program-approved FAQs, triaging patients to appropriate internal or external resources.
  • Manage client and HCP inquiries, ensuring timely follow-ups and resolutions.
• Problem Solving & Advocacy:
  • Advocate for patients facing high prescription costs, offering solutions to ensure access to necessary therapies.
  • Provide consultative support to healthcare teams, helping to overcome obstacles and navigate complex cases.

Qualifications:

• Executive Case Manager:
  • Bachelor’s degree (or 5+ years of relevant experience).
  • 2 years of experience in insurance reimbursement, patient access, direct patient care, or patient education.
• Case Manager:
  • Healthcare experience required (unless you hold a bachelor’s degree and possess strong customer service experience).
  • Medical terminology knowledge preferred.
  • At least 6 months of payer benefits experience (reimbursement, prior auth, etc.).

Skills:

• Strong customer service and communication skills.
• Experience in benefits administration, prior authorization, and benefit verification.
• Ability to handle complex, sensitive conversations with professionalism.
• Detail-oriented, with strong problem-solving and organizational skills.
• Ability to maintain confidentiality and comply with HIPAA and other relevant regulations.

Preferred:

• Bilingual in Spanish or Chinese/Mandarin.
• Previous call center or healthcare experience.
• Proficiency in Microsoft Office and other healthcare technologies.

Why You’ll Love This Role:

• Make an Impact: Help patients access the care they need and navigate complex healthcare systems.
• Collaborative Environment: Work closely with healthcare professionals, patients, and client stakeholders.
• Growth Opportunities: We’re looking for driven individuals who want to grow within the healthcare industry.

Training & Schedule:

• Initial 8-week training program (Monday-Friday, 8:30am - 5:00pm).
• On-site role based in Jeffersonville, IN.

How to Apply:

If you’re ready to make a difference in healthcare and advocate for patients in need, we’d love to hear from you!

This position is perfect for individuals with a passion for patient care and strong problem-solving skills. Apply now and become a key part of our dynamic healthcare team

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 regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.