Insurance Verification Specialist - Specialty Pharmacy

Job Description The purpose of this position is to help patients get access to the medications and therapies that they need. Job Details Snapshot Compensation: $19-22/hr. Location(s): 2160 E. Elliot Road, Tempe, AZ 85283 Onsite Requirement: This role does require onsite availability, but may offer hybrid and/or remote opportunities once requirements are met. Benefits Preloaded PTO: 100 hours (12.5 days) upon employment, increasing to 140 hours (17.5 days) after anniversary. Flexible Culture: Opportunity to work a hybrid schedule after 120 days of training. Career Growth: Opportunities to grow via Advance Gold program. Referral Bonus: $750 for a successful referral. Medical, dental, vision, life, & short-term disability insurance. Teledoc services for employees enrolled in medical insurance. Matching 401(k) with immediate vesting. Legal insurance. A Day in the Life as an Insurance Verification Specialist This role works directly with healthcare providers and insurance plans/payers to gather information about a patient's insurance and the coverage provided for a specific pharmaceutical product. The Insurance Verification Specialist supports the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues, 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 calls 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. Qualifications In-depth understanding and experience with Major Medical & Pharmacy Benefit Coverage. 2 to 3 years of benefit investigation involving the analysis and interpretation of insurance coverage. 2 to 3 years of experience interacting with healthcare providers in regard to health insurance plan requirements. Excellent verbal communication skills and grammar. Salesforce system experience preferred. Equal Opportunity and Other Company Policies AssistRx, Inc. is proud to be an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to race, religion, color, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, family medical history or genetic information, political affiliation, military service, or other non‑merit based factors, or any other protected categories protected by federal, state, or local laws. All offers of employment with AssistRx are conditional on the successful completion of a pre‑employment background check. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. Sponsorship and/or work authorization is not available for this position. AssistRx does not accept unsolicited resumes from search firms or any other vendor services. Any unsolicited resumes will be considered property of AssistRx and no fee will be paid in the event of a hire. #J-18808-Ljbffr AssistRx, Inc.