Insurance Verification Specialist - Specialty Pharmacy

Insurance Verification Specialist

The purpose of this position is to help patients get access to the medications and therapies that they need.

Compensation: $19-22/hr.

Location(s): 495 N Keller Rd, Maitland, FL 32751

Onsite Requirement: This role does require onsite availability, but may offer hybrid and/or remote opportunities once requirements are met.

About AssistRx: Voted Top Work Places in Orlando 3 years in a row, AssistRx understands that the key to success is our fantastic team members. AssistRx has engineered the perfect blend of technology and talent to deliver best in class results. We believe that access to specialty therapies transforms lives and is achieved through the powerful combination of our people and technology. Want to know more? Follow us on LinkedIn to find out how our team members are #TransformingLives.

Why Choose AssistRx:

• Work Hard, Play Hard: Preloaded PTO: 100 hours (12.5 days) PTO upon employment, increasing to 140 hours (17.5 days) upon anniversary. Tenure vacation bonus: $1,000 upon 3-year anniversary and $2,500 upon 5-year anniversary.
• Impactful Work: Join a team that is at the forefront of revolutionizing healthcare by improving patient access to essential medications.
• Flexible Culture: Many associates earn the opportunity to work a hybrid schedule after 120 days after training. Enjoy a flexible and inclusive work culture that values work-life balance and diverse perspectives.
• Career Growth: We prioritize a "promote from within mentality". We invest in our employees' growth and development via our Advance Gold program, offering opportunities to expand skill sets and advance within the organization.
• Innovation: Contribute to the development of groundbreaking solutions that address complex challenges in the healthcare industry.
• Collaborative Environment: Work alongside talented professionals who are dedicated to collaboration, learning, and pushing the boundaries of what's possible. Tell your friends about us! If hired, receive a $750 referral bonus!

A Day in the Life as an Insurance Verification Specialist:

This role works directly with healthcare providers & insurance plans/payers to gather information about a patient's insurance and the coverage provided for a specific pharmaceutical product. The Insurance Verification Specialist will support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues. This position also provides support for Prior Authorizations (PA) for an assigned caseload and helps navigate the appeals process to access medications.

• Ensure cases move through the process as required in compliance with company requirements and the organization's defined standards and procedures; in a manner that provides the best level of service and quality
• Conduct benefit investigations for patients by making outbound phone call to payers to verify patient insurance benefit information, navigate complex reimbursement barriers and seek resources to overcome the barriers
• 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
• Document and initiate prior authorization process and claims appeals
• Report any reimbursement trends or delays in coverage to management
• Act as a liaison for field representatives, health care providers and patients