Benefits Verification Specialist

Summary

Join AssistRx, a top workplace, and become a Benefits Verification Specialist, helping patients access needed medications and therapies. You will work directly with healthcare providers and insurance plans to gather patient insurance information, navigate reimbursement issues, and support prior authorizations. This role involves outbound calls to payers, benefit verification, documentation, and reporting trends to management. After initial on-site training, the position transitions to remote work. AssistRx offers a flexible culture, competitive pay, and various benefits, including generous PTO, tenure bonuses, and a comprehensive benefits package.

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

Responsibilities

• 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

Preferred Qualifications

Salesforce system experience

Benefits

• Preloaded PTO: 100 hours (12.5 days) PTO upon employment, increasing to 140 hours (17.5 days) upon anniversary
• Tenure vacation bonus: $1,000 upon 3-year anniversary and $2,500 upon 5-year anniversary
• Many associates earn the opportunity to work a hybrid schedule after 120 days after training
• We invest in our employees' growth and development via our Advance Gold program, offering opportunities to expand skill sets and advance within the organization
• Medical, dental, vision, life, & short-term disability insurance
• Teledoc services for those enrolled in medical insurance
• Competitive pay structure
• Matching 401(k) with immediate vesting
• Legal insurance
• This role transitions to remote after the first week of training