About the role

  • Insurance Resolution Specialist at PANTHERx handling patient pharmacy and medical claims. Verifying claims, processing authorizations, and coordinating with insurance providers in a hybrid role.

Responsibilities

  • Verifies all benefit information needed to process a claim under pharmacy or medical coverage.
  • Processes pharmacy claims on the patient’s behalf through a pharmacy benefit system.
  • Verifies medical benefits accurately on patient’s behalf.
  • Obtains authorizations & overrides as needed in coordination with insurance providers.
  • Processes patient information for copay cards and/or assistance programs.
  • Discusses with patients a review of patient financial responsibility, and obtains patient consent and payment.
  • Ensures proper shipment set up of prescriptions.
  • Supports special projects.
  • Other tasks as assigned.

Requirements

  • High school diploma or general education degree (GED).
  • Minimum 2 years’ experience processing pharmacy claims and benefit investigation.
  • Strong written and verbal communication skills necessary to convey ideas professionally and effectively.
  • Ability to multitask.
  • Proficient with Cover My Meds (CMM), EDS billing systems, Excel, and Word.

Benefits

  • Hybrid, remote and flexible on-site work schedules are available, based on the position.
  • PANTHERx Rare Pharmacy also affords an excellent benefit package, including but not limited to medical, dental, vision, health savings and flexible spending accounts, 401K with employer matching, employer-paid life insurance and short/long term disability coverage, and an Employee Assistance Program!
  • Generous paid time off is also available to all full-time employees, as well as limited paid time off for part-time employees.
  • Of course we offer paid holidays too!

Job title

Insurance Resolution Specialist

Job type

Experience level

JuniorMid level

Salary

Not specified

Degree requirement

High School Diploma

Location requirements

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