pharmacy benefits specialist

Henry Ford Health

<div><div><p>Join the growing <b>Henry Ford Health Pharmacy Advantage</b> team as a <b>Full-Time Pharmacy Benefits Specialist!</b> Make a meaningful impact on patient care while enjoying a <b>flexible hybrid schedule</b> (In-person + Remote). This role offers a <b>$2,500 sign-on bonus</b> and <b>comprehensive full-time benefits</b>. You'll support patients and providers by helping navigate pharmacy benefits and coordinating prescription services. Be part of a mission-driven team that's improving lives every day! This role is based out of Rochester Hills close door Pharmacy department here at Henry Ford Health.</p><p><b>
GENERAL SUMMARY:</b></p><p>
***Eligible for $2,500 Sign on Bonus***</p><p>
Location: Rochester Hills, MI</p><p>
Schedule: Full- Time Day Shifts</p><p>
In this role, you will collaborate with our Mail Order Services Department within the Henry Ford Health Pharmacy Advantage Team.</p><p><b>
Mail Order Services Department: </b>The Pharmacy Benefits Specialist within the Mail Order Services team will support patients with maintenance medications. Responsibilities include prescription intake, adherence reminder calls, delivery coordination, insurance benefits investigation, prior authorization management, and financial assistance research. The team monitors medication adherence across multiple patient populations, including Medicare, Medicaid, Transplant, Transition of Care, and Commercial. By identifying and addressing patient barriers, our team enhances adherence and health outcomes while delivering exceptional service. This office-based position requires strong computer and phone communication skills. We are seeking career-focused individuals to join our growing, patient-centered, and collaborative pharmacy team.</p><p><i>
This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and duties. It should be understood, therefore, that employees may be asked to perform job-related duties beyond those explicitly described above.</i></p><br>
<p></p>
<div><p><b>EDUCATION/EXPERIENCE REQUIRED:</b></p><ul><li>
Requires a High school diploma or G.E.D. Associates degree preferred</li><li>
Requires State of Michigan Pharmacy Technician License.</li><li>
Requires a minimum of two years of previous pharmacy technician experience.</li><li>
Previous experience as a specialty pharmacy technician preferred.</li></ul>
 </div></div><div><div><div><div><h4 class="jobSectionHeader"><b>Additional Details</b></h4>
<div><p>
This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.</p></div>
</div>
</div></div><div><div><div><h4 class="jobSectionHeader"><b>Overview</b></h4>
<div><p>
Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services &ndash; from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford&rsquo;s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation&rsquo;s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at henryford.com/careers.</p></div>
</div>
</div></div><div><div><div><h4 class="jobSectionHeader"><b>Benefits</b></h4><div><p><br>
</p><p>The health and overall well-being of our team members is our priority. That&rsquo;s why we offer support in the various components of our team&rsquo;s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.
</p></div></div></div></div><div><div><div><h4 class="jobSectionHeader"><b>Equal Employment Opportunity/Affirmative Action Employer</b></h4>
<div><p>
 Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is</p>
<p>
 committed to the hiring, advancement and fair treatment of all individuals without regard to</p>
<p>
 race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,</p>
<p>
 weight, marital status, family status, gender identity, sexual orientation, and genetic information,</p>
<p>
 or any other protected status in accordance with applicable federal and state laws.</p></div></div></div></div></div></div>

Pharmacy Benefits Specialist - Mail Order Services - Full Time Days - Rochester Hills

Onco360

<div><div><b>Are you someone looking for professional career growth? </b>Onco360 Pharmacy is looking for <b>Pharmacy Benefits Verification Specialists</b> for our Pharmacy located in <b>Scottsdale, AZ</b><b>.
</b></div>
<div></div><div><b>Work Hours: </b><b>Monday to Friday - from 9:30am to 6pm AZ local time</b></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><b>Pharmacy </b><b>Benefits 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>Benefits 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>Benefits 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 Benefits 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>

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 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>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 <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>

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