benefit verification specialist

Onco360

<div><div><b>Are you someone looking for professional career growth? </b>Onco360 Pharmacy is looking for <b>Pharmacy Benefit Verification Specialists</b> for our Pharmacy located in <b>Louisville, KY</b><b>.
</b></div>
<div></div><div><div><b>Work Hours: Monday-Friday shifts available; </b><b>some weekends as needed.</b></div><br>
<div></div>
</div><div></div><div><div><b>**Starting salary at $22/hr and up** </b>We also offer quarterly incentive bonuses.</div><br>
<div></div>
<div></div><div>Onco360 is a Closed door specialty pharmacy that focuses on patients who are currently undergoing cancer treatment. Our patients are important to us, so we always strive to meet and exceed their needs. We are seeking <b>Pharmacy Benefit Verification Specialist</b>s who go above and beyond for our patients, and also passionate about helping others.</div>
<div></div><div><div>We offer a variety of benefits including:</div>
<ul><li>Medical, Dental &amp; Vision insurance</li>
<li>401k with a match</li>
<li>Paid Time Off and Paid Holidays</li>
<li>Tuition Reimbursement</li>
<li>Paid Volunteer Day</li>
<li>Floating Holiday</li>
<li>Referral Incentive</li>
<li>Paid Life, and short &amp; long-term disability insurance</li>
</ul>
</div><div></div><div><div><div><b>Pharmacy </b><b>Benefit Verification </b><b>Specialist Summary:</b></div>
<div>The Benefit Verification Specialist will investigate, review, and load accurate patient insurances, including medical and pharmacy coverage, assign coordination of benefits, run test claims to obtain a valid insurance response on patient medications, investigate/identify authorization requirements needed to obtain medication coverage, and enroll eligible patients in copay card assistance programs. They will ensure accurate benefit documentation is made for all prescription orders.</div>
<div></div><div><b>Pharmacy </b><b>Benefit Verification</b><b> Specialist Major Responsibilities:</b></div>
<ul><li>Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests.</li>
<li>Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding benefit information.</li>
<li>Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information.</li>
<li>Performs full benefits verification on patients for pharmacy benefits and/or medical benefit utilizing electronic resources and E1 check to load primary, secondary, tertiary, etc. insurances and medical insurances to patient profile.</li>
<li>Run test claims at each licensed pharmacy site to obtain a valid claim response and determine optimal reimbursement, then document outcome of benefits review in CPR+ system to be used by operations and ensure the order is assigned to the appropriate dispensing pharmacy.</li>
<li>Facilitate process for requesting medical authorizations, LOAs, and TOAs for applicable commercial, Medicaid, and Medicare, or facility medication claims.</li>
<li>Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws</li>
<li>Contributes to team effort by accomplishing related tasks as needed and other duties as assigned.</li>
<li>Conducts job responsibilities in accordance with the standards set out in the Company&rsquo;s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.</li>
</ul></div><div><b>Pharmacy </b><b>Benefit Verification</b><b> Specialist Qualifications:</b></div>
</div><ul><li>Education/Learning Experience
<ul><li>Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification</li>
<li>Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician (PTCB), Specialty pharmacy experience</li>
</ul></li><li>Work Experience
<ul><li>Required: 1+ years pharmacy or benefit verification experience</li>
<li>Desired: 3+ years pharmacy or benefit verification experience</li>
</ul></li><li>Skills/Knowledge:
<ul><li>Required: Pharmacy insurance and benefit verification, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills.</li>
</ul></li><li>Behavior Competencies
<ul><li>Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skills</li>
</ul></li></ul><div><b>#Company Values: Teamwork, Respect, Integrity, Passion</b></div></div></div>

Pharmacy Benefits Verification Specialist

<div><div><b>Are you someone looking for professional career growth? </b>Onco360 Pharmacy is looking for <b>Pharmacy Benefit Verification Specialists</b> for our Pharmacy located in <b>Houston, TX.</b></div>
<div></div><div><div><b>Work Hours: Monday-Friday shifts available; </b><b>some weekends as needed.</b></div><br>
<div></div>
</div><div></div><div><b>**Starting salary at $24.00/hr and up** </b>We also offer quarterly incentive bonuses.</div><br>
<div></div>
<div></div><div><div>We offer a variety of benefits including:</div>
<div></div><ul><li>Medical, Dental &amp; Vision insurance</li>
<li>401k with a match</li>
<li>Paid Time Off and Paid Holidays</li>
<li>Tuition Reimbursement</li>
<li>Paid Volunteer Day</li>
<li>Floating Holiday</li>
<li>Referral Incentive</li>
<li>Paid Life, and short &amp; long-term disability insurance</li>
</ul>
</div><div></div><div><div><b>Pharmacy </b><b>Benefit Verification</b><b> Summary</b></div>
<div>The Benefit Verification Specialist will investigate, review, and load accurate patient insurances, including medical and pharmacy coverage, assign coordination of benefits, run test claims to obtain a valid insurance response on patient medications, investigate/identify authorization requirements needed to obtain medication coverage, and enroll eligible patients in copay card assistance programs. They will ensure accurate benefit documentation is made for all prescription orders.</div>
<div></div><div><b>Pharmacy </b><b>Benefit Verification</b><b> Specialist Major Responsibilities:</b></div>
<ul><li>Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests.</li>
<li>Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding benefit information.</li>
<li>Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information.</li>
<li>Performs full benefits verification on patients for pharmacy benefits and/or medical benefit utilizing electronic resources and E1 check to load primary, secondary, tertiary, etc. insurances and medical insurances to patient profile.</li>
<li>Run test claims at each licensed pharmacy site to obtain a valid claim response and determine optimal reimbursement, then document outcome of benefits review in CPR+ system to be used by operations and ensure the order is assigned to the appropriate dispensing pharmacy.</li>
<li>Facilitate process for requesting medical authorizations, LOAs, and TOAs for applicable commercial, Medicaid, and Medicare, or facility medication claims.</li>
<li>Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws</li>
<li>Contributes to team effort by accomplishing related tasks as needed and other duties as assigned.</li>
<li>Conducts job responsibilities in accordance with the standards set out in the Company&rsquo;s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.</li>
</ul><div><b>Pharmacy </b><b>Benefit Verification</b><b> Specialist Qualifications:</b></div>
</div><ul><li>Education/Learning Experience
<ul><li>Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification</li>
<li>Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician (PTCB), Specialty pharmacy experience</li>
</ul></li><li>Work Experience
<ul><li>Required: 1+ years pharmacy or benefit verification experience</li>
<li>Desired: 3+ years pharmacy or benefit verification experience</li>
</ul></li><li>Skills/Knowledge:
<ul><li>Required: Pharmacy insurance and benefit verification, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills.</li>
</ul></li><li>Behavior Competencies
<ul><li>Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skill</li>
</ul></li></ul><div>Onco360 is a Closed door specialty pharmacy that focuses on patients who are currently undergoing cancer treatment. Our patients are important to us, so we always strive to meet and exceed their needs. We are seeking <b>Pharmacy Benefit Verification Specialists</b> who go above and beyond for our patients, and also passionate about helping others.</div></div><div></div>

<div><div><b>Are you someone looking for professional career growth? </b>Onco360 Pharmacy is looking for <b>Pharmacy Benefit Verification Specialists</b> for our Pharmacy located in <b>New Hyde Park, NY</b><b>.</b></div>
<div></div><div><div><b>Work Hours: Monday-Friday shifts available; </b><b>some weekends as needed.</b></div><br>
<div></div>
</div><div></div><div><div><b>**Starting salary at $25.00/hr and up** </b>We also offer quarterly incentive bonuses.</div><br>
<div></div>
<div></div><div><div>We offer a variety of benefits including:</div>
<div></div><ul><li>Medical, Dental &amp; Vision insurance</li>
<li>401k with a match</li>
<li>Paid Time Off and Paid Holidays</li>
<li>Tuition Reimbursement</li>
<li>Paid Volunteer Day</li>
<li>Floating Holiday</li>
<li>Referral Incentive</li>
<li>Paid Life, and short &amp; long-term disability insurance</li>
</ul>
</div><div></div><div><div><b>Pharmacy </b><b>Benefit Verification</b><b> Specialist Major Responsibilities:</b></div>
<div>The Benefit Verification Specialist will investigate, review, and load accurate patient insurances, including medical and pharmacy coverage, assign coordination of benefits, run test claims to obtain a valid insurance response on patient medications, investigate/identify authorization requirements needed to obtain medication coverage, and enroll eligible patients in copay card assistance programs. They will ensure accurate benefit documentation is made for all prescription orders.</div>
<ul><li>Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests.</li>
<li>Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding benefit information.</li>
<li>Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information.</li>
<li>Performs full benefits verification on patients for pharmacy benefits and/or medical benefit utilizing electronic resources and E1 check to load primary, secondary, tertiary, etc. insurances and medical insurances to patient profile.</li>
<li>Run test claims at each licensed pharmacy site to obtain a valid claim response and determine optimal reimbursement, then document outcome of benefits review in CPR+ system to be used by operations and ensure the order is assigned to the appropriate dispensing pharmacy.</li>
<li>Facilitate process for requesting medical authorizations, LOAs, and TOAs for applicable commercial, Medicaid, and Medicare, or facility medication claims.</li>
<li>Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws</li>
<li>Contributes to team effort by accomplishing related tasks as needed and other duties as assigned.</li>
<li>Conducts job responsibilities in accordance with the standards set out in the Company&rsquo;s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.</li>
</ul><div><b>Pharmacy </b><b>Benefit Verification</b><b> Specialist Qualifications:</b></div>
</div><ul><li>Education/Learning Experience
<ul><li>Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification</li>
<li>Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician (PTCB), Specialty pharmacy experience</li>
</ul></li><li>Work Experience
<ul><li>Required: 1+ years pharmacy or benefit verification experience</li>
<li>Desired: 3+ years pharmacy or benefit verification experience</li>
</ul></li><li>Skills/Knowledge:
<ul><li>Required: Pharmacy insurance and benefit verification, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills.</li>
</ul></li><li>Behavior Competencies
<ul><li>Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skill</li>
</ul></li></ul><div>Onco360 is a Closed door specialty pharmacy that focuses on patients who are currently undergoing cancer treatment. Our patients are important to us, so we always strive to meet and exceed their needs. We are seeking <b>Pharmacy Benefit Verification Specialist</b>s who go above and beyond for our patients, and also passionate about helping others.</div>
<div></div><div><b>#Company Values: Teamwork, Respect, Integrity, Passion</b></div></div></div><div></div>

<div><div><b>Are you someone looking for professional career growth? </b>Onco360 Pharmacy is looking for <b>Pharmacy Benefit Verification Specialists</b> for our Pharmacy located in Waltham, MA.</div>
<div></div><div><div><b>Work Hours: Monday-Friday shifts available; </b><b>some weekends as needed.</b></div><br>
<div></div>
</div><div></div><div><div><b>**Starting salary at $25.00/hr and up** </b>We also offer quarterly incentive bonuses.</div>
<div></div><div><div>We offer a variety of benefits including:</div>
<ul><li>Medical, Dental &amp; Vision insurance</li>
<li>401k with a match</li>
<li>Paid Time Off and Paid Holidays</li>
<li>Tuition Reimbursement</li>
<li>Paid Volunteer Day</li>
<li>Floating Holiday</li>
<li>Referral Incentive</li>
<li>Paid Life, and short &amp; long-term disability insurance</li>
</ul>
</div><div></div><div><div><div><b>Pharmacy </b><b>Benefit Verification </b><b>Specialist Summary:</b></div>
<div>The Benefit Verification Specialist will investigate, review, and load accurate patient insurances, including medical and pharmacy coverage, assign coordination of benefits, run test claims to obtain a valid insurance response on patient medications, investigate/identify authorization requirements needed to obtain medication coverage, and enroll eligible patients in copay card assistance programs. They will ensure accurate benefit documentation is made for all prescription orders.</div>
<div></div><div><b>Pharmacy </b><b>Benefit Verification</b><b> Specialist Major Responsibilities:</b></div>
<ul><li>Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests.</li>
<li>Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding benefit information.</li>
<li>Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information.</li>
<li>Performs full benefits verification on patients for pharmacy benefits and/or medical benefit utilizing electronic resources and E1 check to load primary, secondary, tertiary, etc. insurances and medical insurances to patient profile.</li>
<li>Run test claims at each licensed pharmacy site to obtain a valid claim response and determine optimal reimbursement, then document outcome of benefits review in CPR+ system to be used by operations and ensure the order is assigned to the appropriate dispensing pharmacy.</li>
<li>Facilitate process for requesting medical authorizations, LOAs, and TOAs for applicable commercial, Medicaid, and Medicare, or facility medication claims.</li>
<li>Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws</li>
<li>Contributes to team effort by accomplishing related tasks as needed and other duties as assigned.</li>
<li>Conducts job responsibilities in accordance with the standards set out in the Company&rsquo;s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.</li>
</ul></div><div><b>Pharmacy </b><b>Benefit Verification</b><b> Specialist Qualifications:</b></div>
</div><ul><li>Education/Learning Experience
<ul><li>Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification</li>
<li>Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician (PTCB), Specialty pharmacy experience</li>
</ul></li><li>Work Experience
<ul><li>Required: 1+ years pharmacy or benefit verification experience</li>
<li>Desired: 3+ years pharmacy or benefit verification experience</li>
</ul></li><li>Skills/Knowledge:
<ul><li>Required: Pharmacy insurance and benefit verification, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills.</li>
</ul></li><li>Behavior Competencies
<ul><li>Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skill</li>
</ul></li></ul><div>Onco360 is a Closed door specialty pharmacy that focuses on patients who are currently undergoing cancer treatment. Our patients are important to us, so we always strive to meet and exceed their needs. We are seeking <b>Pharmacy Benefit Verification Specialist</b>s who go above and beyond for our patients, and also passionate about helping others.</div></div></div><div></div>

<div><div><b>Are you someone looking for professional career growth? </b>Onco360 Pharmacy is looking for <b>Pharmacy Benefit Verification Specialists</b> for our Pharmacy located in Woodridge, IL<b>.</b></div>
<div></div><div><b>Work Hours: Monday-Friday shifts available; </b><b>some weekends as needed.</b></div>
<div></div><div><div><b>**Starting salary at $24.00/hr and up** </b>We also offer quarterly incentive bonuses.</div><br>
<div></div>
<div></div><div><div>We offer a variety of benefits including:</div>
<div></div><ul><li>Medical, Dental &amp; Vision insurance</li>
<li>401k with a match</li>
<li>Paid Time Off and Paid Holidays</li>
<li>Tuition Reimbursement</li>
<li>Paid Volunteer Day</li>
<li>Floating Holiday</li>
<li>Referral Incentive</li>
<li>Paid Life, and short &amp; long-term disability insurance</li>
</ul><div><div><b>Pharmacy </b><b>Benefit Verification </b><b>Specialist Summary:</b></div>
<div>The Benefit Verification Specialist will investigate, review, and load accurate patient insurances, including medical and pharmacy coverage, assign coordination of benefits, run test claims to obtain a valid insurance response on patient medications, investigate/identify authorization requirements needed to obtain medication coverage, and enroll eligible patients in copay card assistance programs. They will ensure accurate benefit documentation is made for all prescription orders.</div>
<div></div><div><b>Pharmacy </b><b>Benefit Verification</b><b> Specialist Major Responsibilities:</b></div>
<ul><li>Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests.</li>
<li>Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding benefit information.</li>
<li>Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information.</li>
<li>Performs full benefits verification on patients for pharmacy benefits and/or medical benefit utilizing electronic resources and E1 check to load primary, secondary, tertiary, etc. insurances and medical insurances to patient profile.</li>
<li>Run test claims at each licensed pharmacy site to obtain a valid claim response and determine optimal reimbursement, then document outcome of benefits review in CPR+ system to be used by operations and ensure the order is assigned to the appropriate dispensing pharmacy.</li>
<li>Facilitate process for requesting medical authorizations, LOAs, and TOAs for applicable commercial, Medicaid, and Medicare, or facility medication claims.</li>
<li>Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws</li>
<li>Contributes to team effort by accomplishing related tasks as needed and other duties as assigned.</li>
<li>Conducts job responsibilities in accordance with the standards set out in the Company&rsquo;s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.</li>
</ul></div></div><div><div><b>Pharmacy </b><b>Benefit Verification</b><b> Specialist Qualifications:</b></div>
</div><ul><li>Education/Learning Experience
<ul><li>Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification</li>
<li>Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician (PTCB), Specialty pharmacy experience</li>
</ul></li><li>Work Experience
<ul><li>Required: 1+ years pharmacy or benefit verification experience</li>
<li>Desired: 3+ years pharmacy or benefit verification experience</li>
</ul></li><li>Skills/Knowledge:
<ul><li>Required: Pharmacy insurance and benefit verification, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills.</li>
</ul></li><li>Behavior Competencies
<ul><li>Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skill</li>
</ul></li></ul><div>Onco360 is a Closed door specialty pharmacy that focuses on patients who are currently undergoing cancer treatment. Our patients are important to us, so we always strive to meet and exceed their needs. We are seeking <b>Pharmacy Benefit Verification Specialist</b>s who go above and beyond for our patients, and also passionate about helping others.</div></div></div><div></div>

<div><div><b>Are you someone looking for professional career growth? </b>Onco360 Pharmacy is looking for <b>Pharmacy Benefit Verification Specialists</b> for our Pharmacy located in <b>Buffalo, NY</b><b>.</b></div>
<div></div><div><div><b>Work Hours: Monday-Friday shifts available; </b><b>some weekends as needed.</b></div><br>
<div></div>
</div><div></div><div><div><b>**Starting salary at $22/HR and up** </b>We also offer quarterly incentive bonuses.</div>
<div></div><div><div>We offer a variety of benefits including:</div>
<ul><li>Medical, Dental &amp; Vision insurance</li>
<li>401k with a match</li>
<li>Paid Time Off and Paid Holidays</li>
<li>Tuition Reimbursement</li>
<li>Paid Volunteer Day</li>
<li>Floating Holiday</li>
<li>Referral Incentive</li>
<li>Paid Life, and short &amp; long-term disability insurance</li>
</ul>
</div><div></div><div><div><div><b>Pharmacy </b><b>Benefit Verification</b><b> Summary</b></div>
<div>The Benefit Verification Specialist will investigate, review, and load accurate patient insurances, including medical and pharmacy coverage, assign coordination of benefits, run test claims to obtain a valid insurance response on patient medications, investigate/identify authorization requirements needed to obtain medication coverage, and enroll eligible patients in copay card assistance programs. They will ensure accurate benefit documentation is made for all prescription orders.</div>
<div></div><div><b>Pharmacy </b><b>Benefit Verification</b><b> Specialist Major Responsibilities:</b></div>
<ul><li>Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests.</li>
<li>Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding benefit information.</li>
<li>Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information.</li>
<li>Performs full benefits verification on patients for pharmacy benefits and/or medical benefit utilizing electronic resources and E1 check to load primary, secondary, tertiary, etc. insurances and medical insurances to patient profile.</li>
<li>Run test claims at each licensed pharmacy site to obtain a valid claim response and determine optimal reimbursement, then document outcome of benefits review in CPR+ system to be used by operations and ensure the order is assigned to the appropriate dispensing pharmacy.</li>
<li>Facilitate process for requesting medical authorizations, LOAs, and TOAs for applicable commercial, Medicaid, and Medicare, or facility medication claims.</li>
<li>Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws</li>
<li>Contributes to team effort by accomplishing related tasks as needed and other duties as assigned.</li>
<li>Conducts job responsibilities in accordance with the standards set out in the Company&rsquo;s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.</li>
</ul></div><div><b>Pharmacy </b><b>Benefit Verification</b><b> Specialist Qualifications:</b></div>
</div><ul><li>Education/Learning Experience
<ul><li>Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification</li>
<li>Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician (PTCB), Specialty pharmacy experience</li>
</ul></li><li>Work Experience
<ul><li>Required: 1+ years pharmacy or benefit verification experience</li>
<li>Desired: 3+ years pharmacy or benefit verification experience</li>
</ul></li><li>Skills/Knowledge:
<ul><li>Required: Pharmacy insurance and benefit verification, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills.</li>
</ul></li><li>Behavior Competencies
<ul><li>Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skill</li>
</ul></li></ul><div>Onco360 is a Closed door specialty pharmacy that focuses on patients who are currently undergoing cancer treatment. Our patients are important to us, so we always strive to meet and exceed their needs. We are seeking <b>Pharmacy Benefit Verification Specialist</b>s who go above and beyond for our patients, and also passionate about helping others.</div></div></div>

Optum

<div><p>Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start <b>Caring. Connecting. Growing together.</b></p><p></p><p><br>
The Access &amp; Reimbursement Pharmacy Specialist will be responsible for the benefit verification research and benefit initiation of pharmacy claims. To ultimately obtain patient access the role includes ongoing follow up on prior authorizations and appeals. The role also includes identifying and obtaining financial assistance.</p><p></p><p><br>
This position is under direct supervision from the Access &amp; Reimbursement Supervisor This position relies heavily on the ability to accurately follow directions, thoroughly research, address and communicate prescription insurance coverage requirements as well as a comprehensive knowledge of Medicare, Medicaid and commercial plan structures and standards.</p><p></p><p><br>
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.</p><p></p><p><b><br>
Primary Responsibilities:</b></p><ul><li>
Knowledgeable and proficient in pharmacy benefit structure of all major payer types including government and commercial payers</li><li>
Knowledgeable and proficient in the entire pharmacy prior authorization and appeals process for prescriptions medications</li><li>
Navigate calls to pharmacy benefit manager to determine and obtain patient benefit structure details, initiate overrides, and obtain contracting requirements</li><li>
Completes test claims or electronic verification of benefits when applicable</li><li>
Accurately collect the information required for each program and capture the information in a Customer Relationship Management system (CRM) or database</li><li>
Coordinates with board licensed healthcare professionals including nurses, pharmacists, or supervised pharmacy interns for information needed to complete Prior Authorizations, Appeals and third-party financial assistance forms</li><li>
Follows up with pharmacy plans and third-party financial assistance organizations for general information, status updates and determination details within specified timeframes</li><li>
Effectively explains prior authorization and appeal approval or denial details with customers in a way that is easily understood to fit the audience's needs</li><li>
Keeps current with the requirements and eligibility criteria for copay assistance from public, private, and non-profit organizations related to assigned programs to assist customers with enrolling into third party financial assistance opportunities when applicable. This includes researching foundations available to support the patients' holistic needs</li><li>
Keeps current with existing treatment trends, treatment standards and updated indications related to assigned programs to complete Prior Authorization and Appeal forms</li><li>
Maintains a working knowledge of program guidelines, FAQ's, products, and therapeutic areas related to programs within the Frontier Therapies portfolio</li><li>
Responsible for reviewing, interpreting and reacting to data provided by clients and customers</li><li>
Coordinates the triage of patient prescription to the appropriate partner for fulfillment or administration</li><li>
Communicates customer statuses to the appropriate parties at specified intervals or as needed</li><li>
Resolve customer issues through basic troubleshooting and escalate potential problems or issues that require management's attention in a timely manner</li><li>
Maintains company, employee and customer confidentiality as well as compliance with all HIPAA regulations</li><li>
Provide recommendations to IT partners on system enhancements to better drive performance and quality</li><li>
Completes special duties or projects as assigned by leadership</li></ul><p></p><p><br>
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.</p><p><b>
Required Qualifications:</b></p><ul><li>
2+ years of hands-on Pharmacy Claims Processing, Benefit Verification or Prior Authorization processing in an insurance or pharmacy setting</li><li>
3+ years of retail pharmacy experience</li><li>
Valid license, registration and/or certification, in good standing, to practice as a Pharmacy Technician as required by the Board of Pharmacy in the state employed</li></ul><p></p><p><b><br>
Preferred Qualifications:</b></p><ul><li>
Associate degree</li><li>
Retail Pharmacy experience</li><li>
Specialty Pharmacy experience</li><li>
Pharmacy Accreditation experience</li><li>
Work history working in a matrixed environment, call center, operations environment</li></ul><p></p><p><b><br>
Soft Skills:</b></p><ul><li>
Demonstrated ability to provide quality customer service</li><li>
Ability to manage more than one project or task at a time</li><li>
Meet deadlines and proactively communicates roadblocks</li><li>
Speak, listen and write in a clear, thorough and timely manner using appropriate and effective communication tools and techniques</li><li>
Strive for thoroughness and accuracy when completing tasks</li><li>
Ability to work independently</li><li>
Solid knowledge of Internet navigation and research</li><li>
Willingness to learn and grow in the position</li><li>
Participate in continuous quality improvement activities</li><li>
Be a team player and collaborate across functions</li></ul><p></p><ul><li><br>
All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy</li></ul><p><i>
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.</i></p><p><i>
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.</i></p><p>
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.38 to $36.44 per hour based on full-time employment. We comply with all minimum wage laws as applicable.</p><p></p><p><b><br>
Application Deadline:</b> This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.</p><p><i>
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.</i></p></div>

Access & Reimbursement Pharmacy Specialist

Search 10000+ Benefit verification specialist jobs near you this March. New roles added regularly across leading industries. Apply today.

10000 benefit verification specialist jobs Near Me

Pharmacy Benefits Verification Specialist

Pharmacy Benefits Verification Specialist

Pharmacy Benefits Verification Specialist

Pharmacy Benefits Verification Specialist

Pharmacy Benefits Verification Specialist

Pharmacy Benefits Verification Specialist

Access & Reimbursement Pharmacy Specialist