Insurance Verification Specialist (Pharmacy)

This is your opportunity to join a health-tech enterprise. Apply your pharmacy expertise in a new and exciting way that offers tremendous growth opportunities and the chance to be a part of a company that is revolutionizing pharmacy care.

This is a full-time, onsite position based in Robinson Township.

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 - $18-20/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.

Responsibilities:

• Process pharmacy claims accurately and timely to meet client expectations
• Triage rejected pharmacy insurance claims to ascertain patient pharmacy benefits coverage
• Maintain compliance with patient assistance program guidelines
• Document all information and data discovery according to operating procedures
• Research required information using available resources
• Maintain confidentiality of patient and proprietary information
• Perform all tasks in a safe and compliant manner that is consistent with corporate policies as well as State and Federal laws
• Work collaboratively and cross-functionally between management, the Missouri-based pharmacy, compliance and engineering

Requirements:

• High school diploma or GED required, Bachelor's degree strongly preferred
• One year of Pharmacy Experience, having resolved third party claims
• Appropriate industry experience is necessary
• Strong verbal and written communication skills
• Sound technical skills, analytical ability, good judgment, and strong operational focus
• A passion for providing top-notch patient care
• Ability to work with peers in a team effort and cross-functionally
• Strong technical aptitude and ability to learn complex new software

Hours/Location:

• Shift: 3 available Shift Options
  • 12 PM - 8 PM (Monday - Friday)
  • 1 PM - 9 PM (Monday - Friday)
  • Rotational 40-hour per week shifts are also available between the hours of 8am-9PM (Monday - Friday)
  • *** All shifts require rotational Saturday shift 9am-5pm***
• Onsite full time position in Robinson Township

Benefits:

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

Medix is acting as an Employment Agency in relation to this vacancy.