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AI Summary

The representative will respond to inbound calls regarding pharmacy benefits, prescription coverage, and claim resolutions for members and providers. They are responsible for researching inquiries, documenting interactions accurately, and ensuring compliance with HIPAA and plan requirements.

TekSystems is currently hiring for a FULLY REMOTE Healthcare/Pharmacy Customer Service Representative. This position would be in EST time zone and the approved working states would be: Florida

Georgia

Maryland

New Jersey

North Carolina

Pennsylvania

South Carolina

Texas

MUST HAVE: 2-3 years of healthcare call center/customer service experience, or medical scheduling experience, or something related! Experience with insurance verification or authorizations is a huge plus/also experience with healthcare insurance is also a plus!

Description

This role supports members, providers, pharmacies, brokers, and internal teams with pharmacy benefit and prescription drug coverage questions. Many calls involve members who are actively trying to fill a medication and need timely, accurate support to understand coverage, resolve claim rejections, or identify next steps.

- Respond to inbound calls and inquiries related to commercial pharmacy benefits, prescription coverage, pharmacy claims, and plan information.

- Assist members, providers, brokers, internal teams, and other stakeholders with pharmacy-related questions and issue resolution.

- Research and resolve inquiries using internal systems, routing queues, vendor applications, plan documents, and knowledge resources.

- Review and interpret pharmacy benefit information, policies, procedures, and plan requirements to provide accurate guidance.

- Document all interactions thoroughly and accurately in accordance with compliance and procedural standards.

- Escalate complex issues when needed and coordinate with internal teams or vendor contacts to support resolution.

- Maintain compliance with HIPAA, organizational, plan, and regulatory requirements.

- Meet quality, productivity, and customer experience expectations in a structured, monitored environment.

- Participate in training and coaching to maintain current knowledge of commercial pharmacy benefits, plan requirements, and internal processes.

Additional Skills & Qualifications

Required Qualifications

- High School Diploma or GED required.

- Prior customer service or call center experience required.

- Strong verbal and written communication skills.

- Ability to explain detailed or complex information clearly and professionally.

- Strong attention to detail and accuracy.

- Comfortable navigating multiple systems while assisting callers.

- Ability to work independently and as part of a team.

- Reliable attendance and ability to work in a structured, performance-driven environment.

Preferred Qualifications

- Healthcare call-center or health-plan member-services experience

- Commercial health-insurance or pharmacy-benefit experience

- PBM, prescription-coverage, pharmacy-claims, or prior-authorization experience

- Claims, benefits, insurance, or member-services experience

- Pharmacy technician or pharmacy-support experience

Job Type & Location

This is a Contract position based out of Harrisburg, PA.

Pay and Benefits

The pay range for this position is $19.00 - $20.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

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)

Job Type & Location

This is a Contract position based out of Harrisburg, PA.

Application Deadline

This position is anticipated to close on Oct 29, 2026.

Workplace Type

This is a fully remote position.

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

Were 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. Were 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. Were strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. Were 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.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.

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