Healthcare Claims Processing Specialist

1 week ago


Southfield, Michigan, United States TEKsystems Full time

Career Opportunity:

Remote Position Available After Initial Training Period

Job Title: Case Review / Benefits Specialist

Industry: Medical/Insurance/Benefits

Working Hours: 830AM – 5PM M-F

Compensation: Competitive Pay Rate

Job Overview:

The Case Review Specialist plays a vital role in managing all aspects of in-house communication with patients/clients, referral sources, and ensuring the verification of eligibility, co-payments, and coordination of setup with company providers. This position is integral to the investigative team that addresses product and member-specific needs.

Key Responsibilities:

  • Handle incoming calls and document customer requests for medical equipment in accordance with health plan criteria and diagnoses.
  • Maintain effective communication with patients/clients and referral sources.
  • Address inquiries and resolve issues presented by patients/clients.
  • Set up new patient/client files online, confirming eligibility details and co-payments.
  • Verify involvement of primary care physicians in the equipment ordering process.
  • Review member contact information for delivery accuracy.
  • Ensure completeness and accuracy of online orders before forwarding to providers for setup.

Experience Level:

Entry Level

About TEKsystems:

TEKsystems is a leader in technology services and talent solutions, partnering with clients to unlock new opportunities. With a workforce of 80,000 professionals, we collaborate with over 6,000 clients, including a significant portion of the Fortune 500, across North America, Europe, and Asia. Our commitment to innovation and partnership drives transformative change in the industry. TEKsystems is proud to be an equal opportunity employer, considering 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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