Benefit Verification Specialist - BioPlus Specialty Pharmacy

Job Title Benefit Verification Specialist - BioPlus Specialty Pharmacy Location This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Hours Hours: 11am -7:30pm or 11:30am-8pm EST About the Role BioPlus Specialty Pharmacy is a proud member of the Elevance Health family of companies. BioPlus offer consumers and providers an unparalleled level of service that’s easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer’s treatment journey. The Benefit Verification Specialist - BioPlus Specialty Pharmacy will be responsible for accurately reviewing, verifying, and documenting patient insurance coverage for both medical and pharmacy benefits. This includes loading insurance details, coordinating benefits, and running test claims to confirm coverage and reimbursement outcomes. How you will make an impact Communicating with insurance providers, healthcare teams, and patients to gather and confirm benefit information such as coverage, copays, deductibles, and authorization requirements. Support prior authorizations, appeals, and enrollment in financial assistance programs. Ensure accurate patient setup in the system, monitoring referrals, submitting, and following up on authorization requests, and documenting all findings for operational use. Inform the patient regarding their coverage status, financial obligations, and next steps. Resolve inquiries efficiently, aiming for first-call resolution, while maintaining compliance with regulations and patient confidentiality standards. Collaboration with pharmacy teams and providers to ensure timely medication access and proper claim processing. Minimum Requirements Requires HS Diploma or GED and 1 year of pharmacy or insurance verification experience. Preferred Skills, Capabilities and Experiences Pharmacy Tech lic or certification highly desired. Specialty Pharmacy experience preferred. Pharmacy and Medical claim research experience preferred. Copay card and/or manufacturing experience preferred. Call center experience preferred. General knowledge of company pharmacy services, products, insurance benefits, contracts, and claims preferred. Experience with Medicare (Parts A–D) and specialty pharmacy is preferred. Job Level Non-Management Non-Exempt Workshift 1st Shift (United States of America) Job Family CUS > Care Support Compensation & Benefits merit increases paid holidays Paid Time Off incentive bonus programs (unless covered by a collective bargaining agreement) medical dental vision short and long term disability benefits 401(k) +match stock purchase plan life insurance wellness programs financial education resources EEO & Inclusion Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Compliance & Health Requirements We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. #J-18808-Ljbffr The Elevance Health Companies, Inc.