Insurance Verification Specialist – Specialty Pharmacy
AssistRx
full-time
Posted on:
Location Type: Hybrid
Location: Orlando • Florida • United States
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Salary
💰 $19 - $22 per hour
About the role
- Ensure cases move through the process as required in compliance with company requirements and the organization's defined standards and procedures; in a manner that provides the best level of service and quality
- Conduct benefit investigations for patients by making outbound phone call to payers to verify patient insurance benefit information, navigate complex reimbursement barriers and seek resources to overcome the barriers
- Verify patient specific benefits and document specifics including coverage, cost share and access/provider options
- Identify any coverage restrictions and details on how to expedite patient access
- Document and initiate prior authorization process and claims appeals
- Report any reimbursement trends or delays in coverage to management
- Act as a liaison for field representatives, health care providers and patients
Requirements
- In-depth understanding and experience with Major Medical & Pharmacy Benefit Coverage
- 2 to 3 years of benefit investigation involving the analysis and interpretation of insurance coverage
- 2 to 3 years of experience interacting with healthcare providers in regard to health insurance plan requirements
- Excellent verbal communication skills and grammar
- Salesforce system experience preferred
Benefits
- Medical, dental, vision, life, & short-term disability insurance
- Teledoc services for those enrolled in medical insurance
- Supportive, progressive, fast-paced environment
- Competitive pay structure
- Matching 401(k) with immediate vesting
- Legal insurance
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
benefit investigationinsurance coverage analysisprior authorization processclaims appeals
Soft Skills
verbal communicationinterpersonal skills