Remote Prior Authorization Jobs in Appleton, WI (NOW HIRING)

Are you passionate about helping people navigate healthcare and insurance questions? We are seeking a Member Experience Representative to provide exceptional service and support to members, providers, customers, and brokers. This role is ideal for individuals with healthcare customer service, insurance verification, call center, or health plan experience who enjoy problem-solving and delivering outstanding service.

Training (First 6-8 Weeks):

• Monday-Friday
• 8:00 AM to 4:30 PM CST

After Training:

• Monday-Friday
• 8:00 AM to 4:30 PM CST or 8:30 AM to 5:00 PM CST

• Answer inbound phone calls and email inquiries from members, providers, customers, and brokers.
• Assist with questions regarding:
  • Health insurance coverage
  • Claims status
  • Benefits interpretation
  • Billing inquiries
  • Prior authorizations
• Research and resolve member concerns while striving for first-call resolution.
• Clearly explain health insurance terminology and benefits in a way customers can easily understand.
• Document all interactions accurately in company systems.
• Collaborate with internal departments to resolve issues and ensure a positive member experience.
• Navigate multiple systems and applications simultaneously while assisting callers.
• Protect confidential member information and maintain HIPAA compliance.
• Meet department service metrics and quality standards.

• Minimum of 2 years of healthcare customer service and/or call center experience.
• Experience handling high volumes of phone calls and customer inquiries.
• Proficiency with Microsoft Office applications, including Outlook, Excel, and Word.
• Ability to multitask across multiple computer applications and dual monitors.

• Opportunity to support a growing Medicare business line.
• Competitive compensation with performance-based wage increases.
• Strong career advancement and internal mobility opportunities.
• Continuous learning environment with ongoing training and development.
• Collaborative culture backed by leading healthcare organizations including Froedtert Health and Ascension Wisconsin.

• Must reside in Wisconsin.
• Company equipment pickup required from:
  • Menasha, WI
  • Brookfield, WI

If you have healthcare customer service experience, knowledge of insurance benefits, claims, authorizations, or Medicare, and enjoy helping others navigate complex healthcare questions, we'd love to hear from you!

This is a Contract to Hire position based out of Menasha, WI.

The pay range for this position is $18.25 - $18.25/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)

This is a fully remote position.

This position is anticipated to close on Aug 12, 2026.

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.

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.

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.