Enrollment Representative - Benefit Investigator

Enrollment Representative - Benefit Investigator

As one of the largest and most respected specialty pharmacies, BioPlus creates a meaningful difference to our patients, prescribers, payers, and pharmaceutical partners.

Our 2 - Hour Patient Acceptance Guarantee gives a quick response to prescribers and patients for critical, time - sensitive treatments. As we continue to grow, we need exceptionally talented, bright, and driven people. If you would like to help us continue to be the innovative leader in our industry, this is your chance to join our team.

Job Description

Representative that gathers pertinent verification of insurance benefits and prepares the appropriate documentation in adherence with company's 2-hour brand promise. Works efficiently and provides appropriate and timely information to other departments.

Participation in all aspects of patient's insurance verification functions in adherence to company's 2-hour brand promise.

Responsibilities

• Responsible for accurately completing benefit investigations with adherence to company's 2-hour brand promise
• Must be proficient in Pharmacy Benefit and Major Medical coverage including Commercial, Medicare B and Supplements, Medicare D and State Medicaid
• Responsible for a complete understanding of health insurance benefit structure including copay structure, co-insurance, deductibles, out of pocket, coordination of benefits, etc
• Adjudicate claims through Pharmacy Benefit Managers
• Ability to read and understand paid and rejected claims
• Ability to be able to read Rx and select appropriate dose/units per day supply
• Must have great customer service phone skills with the ability to use persistence and ask the right questions to obtain thorough and accurate information
• Ability to work independently and within a team setting. Must present positive attitude to create a positive work environment
• Adapt to departmental and company procedures as necessary
• Update sales staff and verification team with pertinent information
• Other Duties as assigned by Manager/Supervisor of Admissions Enrollment

Skills & Abilities

• Excellent Computer Skills
• Knowledge of medical terminology
• Excellent communication skills
• Ability to work cooperatively and be a liaison between departments when needed
• Professional image
• Ability to adhere to C.A.R.T. principles

Qualifications

Requirements

• High School Diploma or Equivalent
• At least 1 year of insurance verification experience
• Certified and Registered Technician preferred

BioPlus offers competitive compensation packages including health care, 401(k), growth potential, and a challenging and exciting work environment.

BioPlus is an Equal Opportunity Employer

BioPlus Specialty Pharmacy