senior benefits specialist

Onco360

<div><div>Are you someone looking for professional career growth? Onco360 Pharmacy is looking for Senior Pharmacy Benefit Verification Specialist for our Pharmacy located in Louisville, KY. Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers.
</div>
<div></div><div>Current shift available: 10:30am-7:00pm EST</div>
<div></div><div>**Starting salary at $26/HR and up**</div>
<div></div><div><div>We offer a great benefits including:</div>
<ul><li>Medical; Dental; Vision</li>
<li>401k with a match</li>
<li>Paid Time Off and Paid Holidays</li>
<li>Tuition Reimbursement</li>
<li>Company paid benefits &ndash; life; and short and long-term disability</li>
</ul></div><div><div>Senior Pharmacy Benefit Verification Specialist Major Responsibilities:</div>
<div>The Senior Benefit Verification Specialist will work closely with the Senior Manager, Patient Benefits to ensure completion of challenging cases and escalations in their designated vertical. Senior Benefits Verification Specialists 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. They may also assist with training employees, and other duties as assigned.</div>
<ul><li>Works and resolve difficult or escalated cases to assist in processing prescription orders</li>
<li>Participates in the orientation and training of benefit verification specialists within workflow vertical</li>
<li>Escalates workflow/process improvement ideas to leadership</li>
<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>Senior Pharmacy Benefit Verification Specialist Qualifications:</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: Associates or Bachelor&rsquo;s Degree, Certified Pharmacy Technician (PTCB), Specialty pharmacy experience</li>
</ul></li><li>Work Experience
<ul><li>Required: 2+ 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. 
Desired: Specialty pharmacy experience, leadership skills</li>
</ul></li><li>Licenses/Certifications
<ul><li>Required: Registration with Board of Pharmacy as required by state law</li>
<li>Desired: Certified Pharmacy Technician (PTCB)</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>

Senior Pharmacy Benefit Verification Specialist

Liberty Mutual Insurance

<div>Description
<div>The Senior Claims Specialist works within a Claims Team, using the latest technology to review, analyze and process claims that are routinely characterized as moderately complex to complex within assigned authority limits. This includes making decisions about liability/compensability, evaluating losses, negotiating settlements and managing an inventory of commercial property/casualty claims involving bodily injury or property loss. The Senior Claims Specialist may also assist the Claims Team Manager with assigning new claims to team members, providing technical direction, and monitoring caseloads. 
Responsibilities:<ul><li>
Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages; determines need for, and engages independent adjusters, cause and origin experts and independent medical examiners. Refers to claim to subrogation group or Special Investigations Unit as appropriate.</li><li>
Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim.</li><li>
Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims.</li><li>
Coordinates the litigation activities associated with assigned claims to ensure a timely and cost-effective resolution; attends trials as a representative of the company.</li><li>
Acts as senior technical professional on team, assisting team members with escalated issues. Mentors and trains new team members. Participates in Quality Review process.</li><li>
Participates in conducting Suit Committees, Roundtables, Arbitrations, Mediations, field investigations and may assist in conducting closed file reviews.</li><li>
Performs other duties as assigned.</li></ul></div>
Qualifications<div><ul><li>
Excellent interpersonal skills to communicate and negotiate with customers and conduct investigations required.</li><li>
Leadership ability and demonstrated time management skills to delegate work appropriately and organize resources effectively.</li><li>
Demonstrates an advanced knowledge of claims case handling practices, legal liability, general insurance policy coverage, and the state`s tort laws as normally acquired through a bachelor`s degree (or equivalent training) plus 3 to 5 years directly related work experience.</li><li>
Required to obtain and maintain all applicable licenses.</li></ul></div>
About Us
Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. 
 
At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. 
 
We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: https://www.libertymutualgroup.com/about-lm/careers/benefits 
 
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. 
 
Fair Chance Notices<ul><li>
California</li><li>
Los Angeles Incorporated</li><li>
Los Angeles Unincorporated</li><li>
Philadelphia</li><li>
San Francisco</li></ul></div>

Senior Claims Specialist - WA and OR Jurisdiction Experience

Beacon Communities LLC

Senior Occupancy Specialist, Niagara Square - Buffalo, NY
 Bilingual in English and Spanish Strongly Preferred
 
Our next Senior Occupancy Specialist will manage our Occupancy/Leasing Specialist, driving occupancy at our site, and will complete all the LIHTC recertifications for our residents, helping ensure financial success at the site. LIHTC designations (HCCP, C3P) will substitute for the COS designation.
 General Statement of Duties: Interacts directly with prospective and current residents to achieve maximum occupancy. Acts as the Company’s representative by conveying the benefits of the community. Responsible for the leasing process from introduction to the actual occupancy of the resident.
 
Supervision Received: Reports directly to Property Manager.
 
Supervision Exercised: May supervise Occupancy Specialists both within the property and across the region.
 
FLSA: Non-Exempt
 Essential Functions of the Position: (Any one position may not include all of the duties listed, nor do the listed examples include all that may be found in positions of this class.)
 
<ul>
<li>Provides leadership for the property on occupancy programs and services</li>
<li>Ensure effective working relationships with Area or Roving Occupancy Specialists, corporate staff and Property Management team.</li>
<li>Processes income certifications/recertifications for multiple affordable housing programs and updates Yardi database.</li>
<li>Processes monthly Section 8 Housing Assistance Payment Billing.</li>
<li>Processes and transmits TRACS (Tenant Rental Assistance Certification System).</li>
<li>Greets applicants and provides instruction and guidance to prospective residents during application process.</li>
<li>Coordinates leasing to include intakes, interviews, processing and preparation of applications, and their distribution.</li>
<li>Coordinates and maintains waiting list.</li>
<li>Prepares and maintains office and rental expense budgets.</li>
<li>Assists with rent collection efforts by mailing notices to delinquent residents.</li>
<li>Prepares lease packages and supplemental documents for new move-ins.</li>
<li>Conducts new resident orientation.</li>
<li>Special projects as assigned by property manager.</li>
<li>Fosters a positive, active and collaborative relationship with residents, communities and associated agencies.</li>
<li>Enforces and adheres to company policies, rules and regulations.</li>
<li>Works patiently, professionally and cooperatively with residents and staff to provide high quality customer service.</li>
<li>Preserves and respects resident and applicant confidentiality.</li>
</ul>
Minimum Qualifications: 
Education and Experience: 
<ul>
<li>Associates degree or equivalent is required.</li>
<li>Certified Occupancy Specialist Designation required.</li>
<li>Four plus years sales/leasing experience or equivalent.</li>
<li>Depending on property needs, COS experience with Project Based Section 8, Section 236, Rent Supplement and 13A experience may be needed.</li>
</ul>
Qualifications and Skills: 
<ul>
<li>Strong math proficiency required.</li>
<li>Knowledge of subsidy regulations.</li>
<li>Proficient in Microsoft Office and Excel; highly motivated and able to work independently; ability to handle emergency situations and pressure due to complexity and time-sensitivity; excellent organizational and proofreading skills; attention to detail; strong interpersonal skills; high energy.</li>
<li>Ability to be an active team member within the Company.</li>
</ul>
Beacon Core Competencies required for all positions: Teamwork, Integrity/Ethics, Dependability, Customer Focus, Adaptability/Flexibility.
 
COS Functional Job Competencies required: Job Knowledge, Quality, Self Development, Personal Organization, Productivity, Computer Skills.
 
Compensation: $26.00 - $28.00 per hour
 Actual compensation is influenced by a variety of factors including but not limited to skills, experience, qualifications, and geographic location.
 
Company Overview: 
Founded in 2004, Beacon Communities LLC is a privately-owned real estate firm that develops, acquires, invests in, and manages a wide range of multifamily housing. Beacon currently owns and manages approximately 150 properties including affordable housing, market rate housing, and mixed income-housing. Its developments range from new construction, to historic adaptive reuse, to the renovation of existing housing.
 At Beacon, we strive to make a difference in our residents’ lives. We build outstanding communities that make enduring contributions to the vitality of our cities and towns. We create communities that serve a diverse cross section of our society. Our communities are healthy and vibrant. Why? Because they are planned with care, consideration, and compassion.
 
Benefits Offered: 
At the core of Beacon Communities is the talent on our teams, and we are committed to taking care of our team members so they can deliver great experiences to our residents. That is why we are proud to provide competitive compensation and comprehensive benefits that support a healthy life for you and your family when you join our team.
 
As a regular, full time employee at Beacon you can expect: 
<ul>
<li>Health & Wellness Benefits. We offer plans for quality medical, dental, and vision coverage to all employees regularly scheduled to work a minimum of 24 hours or more per week. HSA/FSA options are also available.</li>
<li>Work-Life Balance. On top of offering 13 paid holidays per year, we have an attractive paid time off policy that includes vacation days, personal days, sick time, wellness days, summer flex time, volunteer days and early close Fridays.</li>
<li>Retirement planning. We offer a 401k program with a company match.</li>
<li>100% Company-Paid Life Insurance. With affordable options to elect voluntary life, critical illness, hospital care or accidental injury coverage.</li>
<li>Access to an Employee Assistance Program (EAP),Childcare & Eldercare Support, Career Development and Advancement Opportunities… and more!</li>
</ul>
Beacon Communities LLC is an Equal Opportunity Employer that seeks a diverse pool of candidates. We are committed to a policy of equal employment opportunity without regard to race, color, ancestry, national origin, religion, disability, gender, gender identity, sexual orientation, age, veteran status or other protected class. All qualified applicants are encouraged to apply. Beacon Communities LLC participates in the E-Verify program.

Senior Occupancy Specialist

CorVel Corporation

<div>The WC Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel.

This role is available for both remote and hybrid work arrangements.

ESSENTIAL FUNCTIONS &amp; RESPONSIBILITIES:
<ul>
<li>Receives Workers&rsquo; Compensation claim, confirms policy coverage and acknowledgement of the claim</li>
<li>Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies</li>
<li>Establishes reserves and authorizes payments within reserving authority limits</li>
<li>Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim</li>
<li>Coordinates early return-to-work efforts with the appropriate parties</li>
<li>Manages subrogation and litigation of claim as it applies</li>
<li>Manages potential claim recoveries of all types</li>
<li>Reports claims to the excess carrier when applicable</li>
<li>Communicates claim status with the customer and claimant</li>
<li>Adheres to client and carrier guidelines and participates in claims review as needed</li>
<li>Develops and maintains professional customer relationships</li>
<li>Complies with rules and regulations of applicable state</li>
<li>Additional duties as assigned</li></ul> 


KNOWLEDGE &amp; SKILLS:
<ul>
<li>Excellent written and verbal communication skills</li>
<li>Ability to assist team members to develop knowledge and understanding of claims practice</li>
<li>Ability to identify, analyze and solve problems</li>
<li>Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets</li>
<li>Strong interpersonal, time management and organizational skills</li>
<li>Ability to work both independently and within a team environment</li>
<li>Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers&rsquo; Compensation</li></ul> 


EDUCATION &amp; EXPERIENCE:
<ul>
<li>Bachelor's degree or a combination of education and related experience</li>
<li>Minimum of 3 years&rsquo; industry experience and claim handling</li>
<li>Self-Insured Certificate preferred</li>
<li>State Certification or license as an experienced claims adjuster</li>
<li>Current license or certification in Workers&rsquo; Compensation must be maintained throughout employment with CorVel</li></ul> 


PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $61,053 - $98,334

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. 


ABOUT CORVEL:

CorVel, a certified Great Place to Work&reg; Company, is a national provider of industry-leading risk management solutions for the workers&rsquo; compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

#LI-Remote</div>

Senior Claims Specialist

<div>The WC Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel.

This is a remote position.

ESSENTIAL FUNCTIONS &amp; RESPONSIBILITIES:
<ul>
<li>Receives Workers&rsquo; Compensation claim, confirms policy coverage and acknowledgement of the claim</li>
<li>Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies</li>
<li>Establishes reserves and authorizes payments within reserving authority limits</li>
<li>Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim</li>
<li>Coordinates early return-to-work efforts with the appropriate parties</li>
<li>Manages subrogation and litigation of claim as it applies</li>
<li>Manages potential claim recoveries of all types</li>
<li>Reports claims to the excess carrier when applicable</li>
<li>Communicates claim status with the customer and claimant</li>
<li>Adheres to client and carrier guidelines and participates in claims review as needed</li>
<li>Develops and maintains professional customer relationships</li>
<li>Complies with rules and regulations of applicable state</li>
<li>Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (&ldquo;IIPP&rdquo;)</li>
<li>Additional duties as assigned</li></ul> 


KNOWLEDGE &amp; SKILLS:
<ul>
<li>Excellent written and verbal communication skills</li>
<li>Ability to assist team members to develop knowledge and understanding of claims practice</li>
<li>Ability to identify, analyze and solve problems</li>
<li>Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets</li>
<li>Strong interpersonal, time management and organizational skills</li>
<li>Ability to work both independently and within a team environment</li>
<li>Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers&rsquo; Compensation</li></ul> 


EDUCATION &amp; EXPERIENCE:
<ul>
<li>Bachelor's degree or a combination of education and related experience</li>
<li>Minimum of 3 years&rsquo; industry experience and claim handling</li>
<li>Self-Insured Certificate preferred</li>
<li>State Certification or license as an experienced claims adjuster</li>
<li>Current license or certification in Workers&rsquo; Compensation must be maintained throughout employment with CorVel</li></ul> 


PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $29.35 - $47.28 per hour

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. 


ABOUT CORVEL:

CorVel, a certified Great Place to Work&reg; Company, is a national provider of industry-leading risk management solutions for the workers&rsquo; compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

#LI-Remote</div>

CA Senior Claims Specialist

CA Senior WC Claims Specialist

Search 10000+ Senior benefits specialist jobs near you this May. New roles added regularly across leading industries. Apply today.

10000 senior benefits specialist jobs Near Me

Senior Pharmacy Benefit Verification Specialist

Senior Claims Specialist - WA and OR Jurisdiction Experience

Senior Occupancy Specialist

Senior Claims Specialist

CA Senior Claims Specialist

CA Senior Claims Specialist

CA Senior WC Claims Specialist