About the Role
Note from FlexJobs Staff: Work from home available after 120 days of training.
Insurance Verification Specialist – Maitland Location Grand Opening
Lockhart, Florida, United States
Patient Access Services
Full time
Description
AssistRx has engineered the perfect blend of technology and talent to deliver best in class results. We believe that access to therapy transforms lives and is achieved through the powerful combination of our people and technology. We leverage advanced custom software, data analytics, and a patient-centered approach to transform medication management into a seamless and efficient process.
As we continue to experience rapid growth and expansion, we are excited to announce multiple openings for talented individuals to join us in our mission. If you are driven by innovation, thrive in a collaborative setting, and are eager to contribute to cutting-edge solutions that transform lives, we want to hear from you.
Join us in making a difference in healthcare technology. At AssistRx, you’ll be part of a team that’s shaping the future of patient care. Apply today and embark on a rewarding journey with us!
About The Role:
The purpose of this position is to help patients get access to the medications and therapies that they need.
This role works directly with healthcare providers & insurance plans/payers to gather information about a patient’s insurance and the coverage provided for a specific pharmaceutical product. The Insurance Verification Specialist will support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues. This position also provides support for Prior Authorizations (PA) for an assigned caseload and helps navigate the appeals process to access medications.
- 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 5 years of benefit investigation involving the analysis and interpretation of insurance coverage
- 3 to 5 years of experience interacting with healthcare providers in regard to health insurance plan requirements
- Excellent verbal communication skills and grammar
- Salesforce system experience preferred