TEKsystems

Insurance

• Handle inbound calls to assess eligibility, explain plan options, provide quotes, and complete enrollments
• Conduct outbound calls during downtime
• Follow CMS, AHIP, and internal compliance guidelines
• Transfer misrouted calls and guide ineligible callers to appropriate resources
• Provide customer service and ensure prospective and current members have plans that meet their needs
• Work rotating shifts, including two weekends per month during October–March

Licensed Health Insurance Agent

Medical Billing and Coding

• Code ambulatory surgery, observation, and ancillary encounters
• Review operative reports and clinical documentation to assign accurate ICD-10, CPT, and HCPCS codes
• Abstract clinical and demographic data into hospital information systems
• Ensure coding accuracy and compliance with CMS, Medicare, Medicaid, AHIMA, and AAPC guidelines
• Assign and validate APCs and support claim readiness
• Collaborate with physicians and clinical staff to clarify documentation as needed
• Assist with emergency department and outpatient diagnostic coding based on department volume
• Meet established productivity, quality, and accuracy standards
• Work assigned encounters through Epic work queues using service-date-based workflow management

Outpatient Surgery Coder

Call Center Representative

• Answer incoming calls from health insurance members regarding coverage and plan availability
• Explain coverage changes and available options
• Research member accounts and accurately document interactions
• Resolve member inquiries while maintaining high-quality customer service standards
• Follow established policies, procedures, and compliance guidelines
• Meet productivity and quality expectations in a fast-paced call center environment
• Support members during significant healthcare insurance service area changes
• Serve as the primary point of contact for questions about healthcare coverage, plan availability, and enrollment impacts

Provider Enrollment Specialist

• Manage provider enrollment processes with various insurance payers
• Review daily email communications for application approvals, requests, and status updates
• Track and update enrollment statuses using spreadsheets and internal systems
• Submit requests and complete enrollment-related actions once provider authorization is obtained
• Contact providers to obtain missing information or required documentation
• Follow up on submitted applications approximately every 15 days
• Maintain accurate records and documentation of enrollment activities
• Handle a high volume of requests, typically between 20 and 70 requests per day
• Use templated email responses while maintaining professional communication
• Follow established outreach and follow-up processes
• Verify requests are appropriate and complete before processing
• Assist with standard enrollments and more complex new provider enrollment cases

Enrollment Specialist

• Serve as the primary point of contact for employees, retirees, and plan participants regarding health, welfare, retirement, and benefits enrollment inquiries during open enrollment and throughout the plan year.
• Educate participants on medical, dental, vision, life insurance, disability, retirement, and other employer-sponsored benefit programs using established plan documents and client-specific policies.
• Respond to inbound phone calls, emails, and case management inquiries in a professional, timely, and customer-focused manner.
• Resolve participant questions and concerns from initial contact through final resolution, ensuring a seamless end-to-end service experience.
• Support participants with online enrollment systems by troubleshooting login issues, navigation questions, and enrollment submission challenges.
• Manage a daily caseload of open participant inquiries, prioritizing tasks to meet established service level agreements and deadlines.
• Adhere to HIPAA, privacy, data security, and confidentiality requirements when handling sensitive personal, health, and financial information.

Open Enrollment Specialist

Procurement

• Execute daily purchasing activities including purchase requisitions, purchase order creation, confirmations, and changes across the full P2P lifecycle
• Manage the complete procure-to-pay workflow from quote through payment
• Obtain supplier quotations and support competitive bidding
• Maintain supplier, pricing, and product data within ERP and procurement systems
• Monitor order status and resolve delays, shortages, pricing discrepancies, and invoice mismatches
• Partner with Accounts Payable to resolve blocked invoices and payment inquiries
• Serve as the primary supplier contact for orders, invoicing, and payment status
• Support supplier onboarding, documentation, and supplier data maintenance
• Ensure compliance with procurement policies, audit requirements, and internal controls
• Identify process gaps and recommend improvements to P2P operations
• Collaborate with cross-functional and global stakeholders on procurement execution

Purchasing Specialist

Representative

• Respond to a high volume of inbound member calls professionally and efficiently
• Assist members with account inquiries, transactions, and service requests
• Support checking and savings accounts, credit cards, consumer loans, IRAs, and other financial products
• Research and resolve member concerns accurately and compliantly
• Educate members on available products, services, and self-service tools
• Review account activity and identify solutions based on member needs
• Document interactions thoroughly and accurately in company systems
• Navigate multiple applications while managing active conversations
• Meet performance expectations for quality, productivity, attendance, schedule adherence, and member satisfaction
• Handle back-to-back inbound calls in a structured 24/7/365 contact center
• Work assigned breaks and meal periods and support required schedule coverage

Member Services Representative

• Review and process patient assistance applications and supporting documentation
• Conduct insurance investigations and verify patient coverage details
• Assess patient financial information to determine program eligibility
• Communicate application outcomes and status updates to patients and healthcare providers
• Deliver high-quality customer service through inbound and outbound phone interactions
• Respond to patient inquiries regarding coverage, eligibility, and program requirements
• Maintain accurate records and documentation in internal systems
• Ensure compliance with HIPAA and all applicable privacy regulations
• Meet productivity, quality, and service-level expectations

Insurance Verification Specialist

• Demonstrate detailed knowledge of clients’ plan provisions and Health and Welfare benefit enrollment
• Assist participants through a concierge service model, addressing inquiries end to end
• Provide proactive, high-quality service and complete inbound inquiries in a timely manner
• Keep participants apprised of case status throughout the process
• Ensure an optimal participant experience when handling inquiries end to end
• Manage open and new cases daily
• Interact with employees, retirement providers, insurance companies, and client services
• Participate in conference calls with retirement providers, insurance companies, and client services

• Demonstrate detailed knowledge of clients’ plan provisions and Health and Welfare benefit enrollment
• Assist participants through a concierge service model, addressing inquiries end to end
• Provide high-quality, proactive service and complete inbound inquiries in a timely manner
• Keep participants apprised of case status throughout the process
• Ensure an optimal participant experience when handling inquiries end to end
• Manage open and new cases daily
• Interact with employees and participate in conference calls with retirement providers, insurance companies, and/or client services

Healthcare Open Enrollment Specialist

Network Engineer

• Support a large-scale End-of-Support (EOS) network refresh initiative
• Migrate customer services from legacy network equipment to newer platforms, primarily in a Juniper-based environment
• Analyze existing router configurations
• Develop migration plans
• Create implementation documentation
• Execute network migrations during scheduled maintenance windows
• Coordinate with multiple internal teams and field resources
• Manage several migration projects simultaneously
• Work independently

• Handle inbound calls to assess eligibility, explain plan options, provide quotes, and complete enrollments
• Conduct outbound calls during downtime
• Follow CMS, AHIP, and internal compliance guidelines
• Transfer misrouted calls
• Guide ineligible callers to appropriate resources
• Provide customer service and help prospective and current members find plans that meet their needs

• Conduct insurance investigations and verify coverage information
• Review and process patient assistance applications and supporting documentation
• Assess patient financial information and determine eligibility
• Communicate application status and outcomes to patients and healthcare providers
• Deliver high-quality customer service while handling complex patient inquiries
• Maintain accurate documentation and case records
• Ensure compliance with HIPAA and privacy guidelines

Customer Support

• Deliver the highest level of customer service experience
• Answer customer calls
• Reset passwords
• Assist with creating accounts
• Upload documents
• Answer general questions
• Engage with customers over the phone and reply to online chat inquiries
• Help customers manage their accounts
• Verify eligibility for coverages and review healthcare options
• Find creative solutions to consumer problems
• Diagnose, assess, and resolve problems or issues in a timely manner
• Maintain expertise in the company, product, and policies
• Complete self-study, training, and testing
• Adhere to regulated communication guidelines across all channels
• Interpret and follow defined procedures and policies
• Input customer information into a database
• Perform various administrative duties as assigned

Bilingual Customer Service Representative

• Execute daily purchasing activities including purchase requisitions, purchase order creation, confirmations, and changes across the full P2P lifecycle
• Manage the complete procure-to-pay workflow from quote through payment
• Obtain supplier quotations and support competitive bidding
• Maintain accurate supplier, pricing, and product data in ERP and procurement systems
• Monitor order status and resolve delays, shortages, pricing discrepancies, and invoice mismatches
• Partner with Accounts Payable to resolve blocked invoices and payment inquiries
• Serve as the primary supplier contact for orders, invoicing, and payment status
• Support supplier onboarding, documentation, and supplier data maintenance
• Ensure compliance with procurement policies, audit requirements, and internal controls
• Identify process gaps and recommend improvements to P2P operations
• Collaborate with cross-functional and global stakeholders to ensure timely, accurate procurement execution