New

Reimbursement Case Manager

TEKsystems
$37,440.00 - $45,760.00 / yr
401(k)
United States, North Carolina, Morrisville
Jul 17, 2025
Description * Reimbursement Case Managers will serve as an expert on reimbursement, co-pay, and foundation assistance * Reimbursement Case Managers will serve as an expert on all aspects of benefit coordination and other forms of available support. * Strong working knowledge and ability to understand and explain benefits offered by all payer types, including private/commercial and government (i.e., Medicare, Medicaid, VA and DOD); with expertise in Medicare Part B * Navigates through payer challenges by asking appropriate questions to obtain the necessary result * Serve as a resource for patients and healthcare professionals to verify insurance coverage, medical billing, reimbursement process, and general access for complex pharmaceuticals * Escalate complex cases according to program policy and procedures. * Evaluate program enrollment forms for data integrity * Responsible for insurance benefit investigations, and triage cases according to program standard operating procedures * Follow program guidelines and escalate complex cases according to program policy, SOPs, Call Guides, and other program materials. * Working case management system, documenting status/background in case notes, assisting in the PA/Appeals process, and like responsibilities * Maintain records in accordance with applicable standards and regulations for the programs/promotions * Identify and report pharmacovigilance information as required by client(s)(i.e., Adverse Events)-(specific to program/client requirements) * Provide unparalleled while serving as a brand advocate and program representative; understands the importance of achieving quality outcomes and commits to the appropriate use of resources * Works with the Program Manager on a day-to-day basis to maintain open lines of communication and share awareness regarding patient status, payer feedback/satisfaction, and program effectiveness * Understand the health and disease states of patients in the programs * Maintains a high level of ethical conduct regarding confidentiality and privacy * Help maintain team morale by consistently demonstrating a positive attitude * On-time adherence to training deadlines for all corporate policies and procedures governing access to confidential data * Ensure all SOPs are followed with consistency * Conducts miscellaneous tasks or projects as assigned. Identify and report pharmacovigilance information as required by client(s) (i.e., Adverse Events) - (specific to program/client requirements) * Other responsibilities assigned based on specific to program/client requirements. Skills Required Insurance verification Prior authorization Case management Benefit investigation Medicare part D, Benefit delivery Pharmaceutical insurance Additional Skills & Qualifications Associate or bachelor's degree and 2 years of reimbursement/insurance, healthcare billing, physician office, health insurance processing preferred, or in lieu of a degree, a High school diploma or equivalent with 5 years of reimbursement/insurance, healthcare billing, physician office, health insurance processing Experience Level * Entry Level Pay and Benefits The pay range for this position is $37440.00 - $45760.00/yr. 401K w/ 5% matching; day-1 vestment period 15 days PTO 8 Holidays + 2 Floating Days Health/Dental/Vision/Life; Coverage day-1 Gym Reimbursement Volunteer Hours Flexibility/Hybrid/Remote** Workplace Type This is a hybrid position in Morrisville,NC. Application Deadline This position is anticipated to close on Jul 24, 2025. h4>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. About TEKsystems and TEKsystems Global Services We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. 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.