Reimbursement Specialist

Reimbursement Specialist

100% REMOTE – must reside in IN, OH, KY, TX, FL, MI, or IL

Monday-Friday: start time between 7am-8:30am then will work 8 hours (eastern time zone)

Job Description:

The primary purpose of this role is to jump in and help with denials within the commercial lines of insurance. Responsible for managing all aspects of accounts receivables to ensure maximum and timely reimbursement for hospital billing and claims. This role requires staying current on payer-specific regulations and procedures and providing written summaries of findings and recommendations.

This is a customer-focused position with a strong emphasis on accounts receivable management. The representative will follow established guidelines to recover delinquent accounts, place calls to payers, and assist in maintaining Network A/R days. Follow-up may also be conducted via payer websites. Remote work flexibility is available after the initial training period.

Responsibilities:

• Adhere to all network and departmental procedures and policies
• Comply with applicable state/federal laws and accreditation requirements
• Document all account actions clearly and accurately
• Maintain patient confidentiality
• Resolve denials and insurance correspondence within specified timeframes
• Follow billing and collection procedures, providing necessary information to adjudicate claims
• Meet A/R, productivity, and QA standards set by the department
• Monitor billing and follow-up holds to ensure timely resolution
• Participate in monthly payer conference calls

Must-Have Qualifications:

• 2+ years of medical billing experience, specifically handling denials with commercial payers (e.g., Anthem, Cigna, UHG, Humana, Aetna)
• Experience with government plans (Medicare, Medicaid, Tricare, HIP Plans)
• Strong understanding of reimbursement methodologies and contract pricing logic

Nice-to-Have Qualifications:

• Candidates with only government plan experience will be considered
• Experience with EPIC is highly desirable

Pay and Benefits

The pay range for this position is $20.00 – $23.00/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 the following:

• 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)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Jun 30, 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.

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