Benefits Verification Specialist - Specialty Pharmacy

Benefits Verification Specialist works directly with healthcare providers and insurance plans to gather information about patient's insurance and coverage for specific pharmaceutical products. Supports healthcare providers with questions regarding coding and billing, and navigates complex reimbursement issues. Provides support for Prior Authorizations and helps navigate the appeals process.

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

• Preloaded PTO: 100 hours (12.5 days) PTO upon employment, *prorated based on start date, increasing to 140 hours (17.5 days) upon anniversary
• 9 paid holidays annually
• Tenure vacation bonus: $1,000 upon 3-year anniversary and $2,500 upon 5-year anniversary
• Medical, dental, vision, life, & short-term disability insurance
• Matching 401(k) with immediate vesting