Pharmacy Ins Verific Rep

Insurance Verification Specialist

This employee is responsible for the verification of customer insurance benefits (Medicare and Secondary Insurance) for potential reimbursement, as well as the creation and maintenance of specified data files.

Job Responsibilities:

• Receive verification of benefits for new and existing customers
• Contact insurance companies to verify customer coverage and obtain information concerning extent of benefits and billing requirements
• Contact center as necessary for information or problems
• Complete verification request form deemed necessary
• Create, update, and maintain integrity of payer responsibility and referral sources
• Fax verification request form back to appropriate center and/or forward information to team members
• Record all activity specifically relating to account in PAC tickler file
• Confirm Medicare Part B benefits with physician offices via telephone
• Obtain pre-certification from insurance companies for nebulizer compressors as needed
• Enter information in Pharmacy software
• Obtain written insurance verifications via fax as needed
• Achieve goals set by management and/or department leads

Qualifications:

• Past performance shows solid evidence of insurance qualifications and guidelines
• Knowledge of telephone etiquette, with adequate oral and written communication skills
• Shows effective multitasking skills
• Basic computer skills
• Positive and cooperative attitude in working and communicating with individuals at all levels of the organization
• Knowledge of Respiratory Health Care is helpful
• In some states, the ability to obtain a Pharmacy Technician License may be required

Education and Experience:

• High School Diploma or General Education Degree (GED) required
• One to three months of related experience and/or training, or equivalent combination of education/experience