Job Title: Insurance Verification Specialist – Pharmacy/Medications Focus
Location: Pittsburgh, PA
Job Type: Full-Time
Hours: Monday-Friday with one Saturday a month
Pay: Pending relevant years of experience - $18-22/h
Job Overview: As an Insurance Verification Specialist, you will play a key role in the pre-authorization process, verifying insurance coverage, and assisting patients in accessing their medications. You will work closely with pharmacies, healthcare providers, and insurance companies to navigate insurance requirements, with a strong focus on prior authorizations and medication-related processes.
Key Responsibilities:
- Verify insurance eligibility and coverage for prescribed medications.
- Obtain prior authorizations from insurance companies, ensuring timely and accurate completion.
- Review and interpret insurance policies to determine benefit coverage for medications.
- Communicate with healthcare providers, pharmacies, and insurance companies to resolve any issues with prior authorizations or coverage.
- Maintain detailed and accurate records of patient information, insurance status, and authorizations.
- Stay up-to-date with insurance regulations and changes in prior authorization processes.
- Provide excellent customer service to patients, addressing any questions or concerns regarding their insurance and medication coverage.
Qualifications:
- Minimum of 2 years of experience in insurance verification or prior authorization in a healthcare setting, preferably in a pharmacy or medication-focused environment.
- Strong knowledge of medical and pharmacy insurance policies, procedures, and prior authorization processes.
- Experience working with insurance companies, specifically handling medication-related claims and authorizations.
- Exceptional communication and organizational skills with the ability to manage multiple tasks simultaneously.
- Proficient in healthcare-related software and systems for tracking authorizations and patient information.
- Detail-oriented, with a strong commitment to accuracy and compliance.
Preferred Qualifications:
- Previous experience working in a pharmacy or handling prior authorizations for medications.
- Knowledge of Medicaid, Medicare, and commercial insurance plans.
Benefits:
- Competitive salary and comprehensive benefits package
- Health, dental, and vision insurance
- 401(k) with company match
- Career development and advancement opportunities
