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 four weeks of on-site training, the position transitions to remote work with occasional on-site visits. AssistRx offers a competitive compensation package, including PTO, tenure bonuses, and various benefits.

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
• 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
• #TransformingLives Honor: This quarterly award program is a peer to peer honor that recognizes and highlights some of the amazing ways that our team members are transforming lives for patients on a daily basis
• Values Award: This quarterly award program recognizes individuals who exhibit one, or many, of our core company values; Excellence, Winning, Respect, Inspiration, and Teamwork
• Vision Award : This annual award program recognizes an individual who has gone above and beyond to support the AssistRx vision to transform lives through access to therapy
• If hired, receive a $750 referral bonus!