Insurance Verification Specialist

Location: On-site in Chesterfield, MO.
Pay: $19/hour
Schedule: Monday-Friday 8:00 AM - 9:30 PM, Saturday 9:00 AM - 5:00 PM (one Saturday a month, with a mid-week day off). Schedule provided two weeks in advance. Flexibility is required, especially during Q4, our busiest time of year.

Are you passionate about helping patients get the best access to their medications at the best prices? Join our dynamic Pharmacy Technology Company that focuses on providing excellent service to patients navigating their prescription benefits. We are looking for detail-oriented and adaptable individuals to join our team as Pharmacy Claims Specialists.

Key Responsibilities:

• Accurately and efficiently process pharmacy claims, ensuring timely submission.
• Triage rejected claims and work to identify coverage solutions for patients.
• Initiate prior authorization requests with healthcare providers and identify the correct forms needed for different insurance companies.
• Coordinate with prescribers and medical offices to ensure accurate completion of prior authorization forms.
• Follow up on prior authorization requests, providing updates to both patients and providers.
• Collaborate with medical offices to manage Appeals.
• Serve as a resource for internal teams regarding prior authorization inquiries.
• Adhere to patient assistance program guidelines and document all findings per operational procedures.
• Maintain patient and proprietary information confidentiality.

Requirements:

• High school diploma or GED required (Bachelor's degree preferred).
• Minimum of one year of experience in healthcare, with pharmacy claims experience strongly preferred.
• Exceptional verbal and written communication skills.
• Technical proficiency with the ability to learn and adapt to new software.
• Strong analytical thinking and attention to detail.
• Commitment to providing top-notch patient care.
• Ability to work effectively within a team and cross-functionally.

Ideal Candidates May Come From:

• Pharmacy business office or pharmacy tech background.
• Physician office, hospital, or revenue cycle management (RCM) experience.
• Centralized scheduling or intake roles within healthcare organizations.
• Health plan claims processing backgrounds.

If you are looking for a fast-paced environment where every day brings a new challenge and the opportunity to make a difference in patient care, apply today!

Why Join Us?

• Contribute to meaningful work in a growing company that helps patients receive essential medications.
• Thrive in a collaborative team environment with opportunities for growth.
• Be a part of a company that values flexibility, teamwork, and innovation.
  
  Benefits:

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances)

• Health Benefits / Dental / Vision (Medix Offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s).)

• 401k (eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1)

• Short Term Disability Insurance

• Term Life Insurance Plan