Patient Benefit Representative/ Reimbursement Specialist

Responsibilities Locate and enter accurate prescription insurance information into patient profiles by processing eligibility checks and adjudicating pharmacy claims. Adjudicate claims and troubleshoot claim rejections while communicating accurate information to patients. Communicate prior authorization (PA) requirements to providers and support them throughout the PA process. Handle inbound calls from patients, physicians, clinics, practitioners, and clients regarding order status, services, and financial assistance options. Serve as a resource for claim adjudication processes and identify opportunities for improvement. Enter detailed and accurate documentation into patient profiles. Contact patients to schedule medication deliveries and collect payment information. Coordinate patient refills and follow‑up activities to support therapy adherence. Identify and report adverse events (AEs) and product complaints (PCs) to appropriate clinical personnel. Perform additional duties as assigned based on program requirements. Preferred Qualifications Previous healthcare, pharmacy, insurance verification, or patient support experience. Strong customer service and communication skills. Experience handling insurance claims, benefit investigations, or prior authorizations. Ability to multitask in a fast‑paced environment. Strong attention to detail and documentation skills. Proficiency with computer systems and data entry. #J-18808-Ljbffr Avacend