Insurance Verification Analyst

Job Description:

• Provide subject matter expertise on medical and prescription insurance coverage, verification, claim billing, medication prior authorization, appeal filing, and alternate financial assistance opportunities
• Accurately document information in appropriate systems and formats
• Communicate referral status to physicians and patients via phone, fax, and/or the core pharmacy system
• Assist offices through prior authorization and appeal documentation and filing
• Monitor authorization and appeal status to support rapid turnaround and patient access to medication
• Use internal and web tools to investigate pharmacy and medical benefits
• Collaborate with health insurance payors and providers and maintain payor intelligence resources
• Enter patient demographic and health insurance information into the hub information system
• Notify physicians of incomplete or incorrect insurance information

Requirements:

• 1-3 years of work experience in a healthcare or reimbursement setting
• Previous experience in a call center environment, healthcare office, corporate setting, healthcare insurance provider, or pharmacy is required
• Thorough understanding and knowledge of commercial and government pharmacy and medical insurance programs
• Knowledge of billing, alternate funding resources, reimbursement processes, insurance verification, prior authorization and appeal filings, and specialty pharmacy operations
• Pharmacy call center experience preferred for A+ candidates
• Healthcare call center and medical claims experience preferred for A- candidates

Benefits:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital coverage
• 401(k) Retirement Plan with pre-tax and Roth post-tax contributions
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)