Specialist, Insurance II

📋 Description

• Primary contact for Health Care Providers and patients on insurance access challenges
• Provide insurance coverage, verification, prior authorization status, and alternate funding options
• Educate customers on plan forms, portals, and appeal submissions
• Investigate escalated access issues and complete benefit investigations when needed
• Learn and implement changes to processes and systems for all drugs and sources
• Document information in the proper systems and communicate insurance details to HCP/patients

🎯 Requirements

• High school diploma or GED; degree preferred
• 2-4 years in healthcare or reimbursement; call center or healthcare office preferred
• Knowledge of commercial/government insurance, prior authorization, and alternate funding
• Experience with Medicare Part D, Medicaid, private payers, and pharmacy/medical benefits preferred
• Strong leadership, communication, and organization; detail-oriented
• Proficient with Microsoft Office and other computer systems

🎁 Benefits

• Comprehensive benefits package including PTO, medical/dental/vision, and 401(k)
• Eligible to participate in short-term incentive programs