Insurance Verification Representative

Description:

Summary:

As a Patient Access Specialist within our Clinical Services Team, you are responsible for assisting our patient members with obtaining critical medications. You serve as our patient members’ advocate and guide them through the complex world of prescriptions to help them obtain medications in a cost-effective and timely manner. You are the critical link between patient members, healthcare providers/ doctors, and pharmacies.

Job Duties:

- Assist patient members with enrollment in drug savings programs

- Coordinate with patient members/ physicians/ drug manufacturers on applications to drug assistance programs

- Coordinate with programs and/or pharmacies to ensure the continuation of therapy

- Directly communicate with patient assistance programs to facilitate the approval of medications

- Take inbound and make outbound calls to members, providers, and pharmacies

- Manage every call by accurately resolving the issue, demonstrating compassion, meeting compliance requirements, and ensuring a hassle-free experience for our members.

- Assist patient members with enrollment in drug savings programs (copay cards, procurement via international - sources)

- Educate patient members about their pharmacy benefits and serve as a patient advocate to help them source necessary medications they need

- Coordinate with patient members, physicians, drug manufacturers, and pharmacies with enrollment into copay card

- Manage every call by accurately resolving the issue, demonstrating compassion, meeting compliance requirements, and ensuring a hassle-free experience for our members

Skills:

case work, case processing, patient service, healthcare customer service, benefit verification, insurance verification, pharmacy, insurance, prior authorization, patient scheduling, medical reception, patient access, patient registration

Top Skills Details:

case work,case processing,patient service,healthcare customer service,benefit verification,insurance verification

Additional Skills & Qualifications:

Requirements:

- Must have 2+ years of Administrative Healthcare Experience where they were doing any of the following: Insurance Verification, Prior Authorization, Case Management or Coordination,pharmacy tech

- Proficiency in Mac, MS Office, G-Suite required

- Valid Pharmacy Technician certificate is a plus

- Active listening, conversational speaking skills, with a high degree of empathy

- Demonstrate problem-solving skills, information gathering, research, alternatives analysis, applying creative solutions to unique

• Onsite in Plano, TX, hours open 7A - 7 P M-F