Senior Analyst developing state product initiatives to meet financial objectives for Personal Insurance. Identify, implement, and ensure compliance with state regulations and guidelines.
About the role
- AssistRx seeks an Insurance Verification Specialist to help patients access essential medications and therapies. Collaborate with healthcare providers and insurers to navigate benefits and authorizations.
Responsibilities
- Help patients get access to the medications and therapies that they need
- Work directly with healthcare providers & insurance plans/payers to gather information about a patient’s insurance and coverage
- Support healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues
- Provide support for Prior Authorizations (PA) for an assigned caseload
- Document and initiate prior authorization process and claims appeals
- Conduct benefit investigations for patients by making outbound calls to payers
- 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
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
- Salesforce system experience preferred
Benefits
- Medical, dental, vision, life, & short-term disability insurance
- Teledoc services for those enrolled in medical insurance
- Supportive, progressive, fast-paced environment
- Competitive pay structure
- Matching 401(k) with immediate vesting
- Legal insurance
- Preloaded PTO: 100 hours (12.5 days) PTO upon employment
- Tenure vacation bonus: $1,000 upon 3-year anniversary and $2,500 upon 5-year anniversary
- Quarterly awards recognizing outstanding employee contributions
Job title
Job type
Experience level
Salary
Degree requirement
No Education Requirement
Location requirements
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