Insurance Verification Specialist

Job Title: Insurance Verification Specialist - Pharmacy/Medications Focus

Location: Pittsburgh, PA

Job Type: Full-Time

Hours: Monday-Friday with one Saturday a month

Pay: Pending relevant years of experience - $18-22/h

Job Overview: As an Insurance Verification Specialist, you will play a key role in the pre-authorization process, verifying insurance coverage, and assisting patients in accessing their medications. You will work closely with pharmacies, healthcare providers, and insurance companies to navigate insurance requirements, with a strong focus on prior authorizations and medication-related processes.

Key Responsibilities:

• Verify insurance eligibility and coverage for prescribed medications.
• Obtain prior authorizations from insurance companies, ensuring timely and accurate completion.
• Review and interpret insurance policies to determine benefit coverage for medications.
• Communicate with healthcare providers, pharmacies, and insurance companies to resolve any issues with prior authorizations or coverage.
• Maintain detailed and accurate records of patient information, insurance status, and authorizations.
• Stay up-to-date with insurance regulations and changes in prior authorization processes.
• Provide excellent customer service to patients, addressing any questions or concerns regarding their insurance and medication coverage.

Qualifications:

• Minimum of 2 years of experience in insurance verification or prior authorization in a healthcare setting, preferably in a pharmacy or medication-focused environment.
• Strong knowledge of medical and pharmacy insurance policies, procedures, and prior authorization processes.
• Experience working with insurance companies, specifically handling medication-related claims and authorizations.
• Exceptional communication and organizational skills with the ability to manage multiple tasks simultaneously.
• Proficient in healthcare-related software and systems for tracking authorizations and patient information.
• Detail-oriented, with a strong commitment to accuracy and compliance.

Preferred Qualifications:

• Previous experience working in a pharmacy or handling prior authorizations for medications.
• Knowledge of Medicaid, Medicare, and commercial insurance plans.

Benefits:

• Competitive salary and comprehensive benefits package
• Health, dental, and vision insurance
• 401(k) with company match
• Career development and advancement opportunities