Benefits Verification Representative

• Assists with insurance verification and authorization
• revenue cycle management
• copay assistance and issue resolution and follow up
• Provides support to referral sources and pharmacy team to ensure timely processing of referrals
• Gathers necessary information to verify critical member benefits insurance coverage
• Reviews insurance plans and policies to determine the extent of coverage
• Contacts insurance providers to verify eligibility, coverage limits, pre-authorization requirements, and any specific benefits relevant to member services or treatments
• Explains the verification process, provides updates on the status of benefits verification, and addresses any questions or concerns related to coverage or financial responsibility
• Communicates any authorization requirements, coverage limitations, or pre-certification processes to ensure smooth billing and claims processing
• Investigates and resolves any challenges or conflicts that may arise during the verification process
• Proposes process enhancements, automation, or system improvements to streamline operations and enhance the overall effectiveness of benefits verification activities
• Works with pharmacy team to provide promptly and professionally, ensuring a positive customer experience

• At least 1 year work experience
• Specialty Pharmacy experience
• High School diploma

Specialty Pharmacy experience

• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
• paid time off
• flexible work schedules
• family leave
• dependent care resources
• colleague assistance programs
• tuition assistance
• retiree medical access