What are the responsibilities and job description for the Insurance Specialist position at McKesson?
Works in a fast-paced, high-volume contact center environment to provide product-specific reimbursement support to patients, healthcare providers, patient advocates, and manufacturer representatives. Will frequently interact via telephone with commercial payers to conduct insurance verifications and benefit investigations. Works daily with commercial payers to ensure appropriate coverage and reimbursement in a variety of therapeutic areas. Must have a solid working knowledge of insurance plans and benefit structures in order to obtain detailed benefit information and maximize plan benefits. Obtains payer-specific prior authorization procedures and documentation requirements, if applicable, and facilitates the prior authorization process for patients and healthcare providers. A general understanding of Medicare and Medicaid programs is desired. Position may require sales, project management and/or account coordination skills depending on the specific program.
Key Responsibilities
- Contact payers to verify patient eligibility and product-specific coverage information.
- Interface with physicians, advocates, patients, and manufacturer representatives to obtain and provide drug-specific coverage information.
- Provide prior authorization assistance as well as claims assistance, including billing and coding instructions, to physicians and/or office staff.
- Provide accurate and timely follow-up to all reimbursement inquiries in accordance with program guidelines.
- Ensure that the intake information is accurate and complete in order to perform all reimbursement research.
- Research and compile payer-specific information for reimbursement database.
- Utilize internal resources to identify and provide alternate funding sources for patients without insurance or adequate coverage through their insurer.
Minimum Requirements
- 2+ years' experience within a healthcare environment.
- Medical claims experience.
Critical Skills
- Experience in the healthcare industry including, but not limited to, insurance verification and/or claim adjudication, physician’s office or outpatient billing, pharmacy and/or pharmaceutical manufacturers.
- Must be able to compose and document benefit investigation outcomes and prepare written status reports to management on a regular basis.
Additional Knowledge/Skills
- ICD-10, HCPCS and CPT experience
- Ability to effectively handle multiple priorities within a changing environment
- Interpersonal skills
- Strong written and oral communication skills
- Strong organizational skills
- Proficient in MS Office
- Problem-solving and decision-making skills
Education
HS Diploma or equivalent
Physical Requirements
Professional office environment – this position requires the availability between 6:00 am – 6:00 pm Arizona time
CAREER LEVEL: B2
McKesson is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.Qualified applicants will not be disqualified from consideration for employment based upon criminal history.McKesson is committed to being an Equal Employment Opportunity Employer and offers opportunities to all job seekers including job seekers with disabilities. If you need a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to Disability_Accommodation@McKesson.com. Resumes or CVs submitted to this email box will not be accepted.Current employees must apply through internal career site.Join us at McKesson!
