What are the responsibilities and job description for the Insurance Verification Specialist (Benefit Specialist) position at PharmaCord?
Important Notice
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Please Note:
- PharmaCord will never use Microsoft Teams to reach out to candidates for interview scheduling. However, video interviews are typically conducted via Microsoft Teams. Official meeting links will always be sent from an @pharmacord.com or @echo.newtownsoftware.com email address, or through our scheduling platform, Calendly.
- We will never request your bank account information at any stage of the hiring process.
- We will never send a check (electronic or physical) to purchase home office equipment.
If you receive any suspicious communication regarding employment with PharmaCord, please report it to our Talent Acquisition team immediately at careers@pharmacord.com
When you join the team as the Insurance Verification Specialist (Benefits Specialist), you'll have the opportunity to make a difference in the lives of our patients each day as they look to you as part of their dedicated support team for helping them navigate the tricky process to getting access to their complex medication. You'll compassionately deliver an exceptional experience to many patients per day always remembering that every prescription or document belongs to a real person who is looking for thorough and efficient management of their records. You'll adjust your approach to their needs by communicating clearly, focusing on the accuracy of the details of their medical records and your mastery of the program requirements, and ensuring their prescriptions or cases are handled timely. This role may be eligible for a hybrid schedule after 6 months (or sooner once proficiency in role is demonstrated). Review our Benefits & Perks below to learn more!
A typical day in this role will include providing in-depth knowledge of our client programs by working directly with patients, healthcare providers, and insurance companies to answer inquiries, process service requests, assess benefits coverage, and manage through barriers, in a compliant manner, that stand in the way of patients and their access to therapy. The Insurance Verification Specialist (Benefits Specialist) works in a dynamic and compassionate customer service role providing telephonic and web-based, where applicable, customer service support.
A typical day in the life of a Insurance Verification Specialist (Benefits Specialist) will include the following:
The responsibilities include, but are not limited to the following:
- Benefit Verification:
- Performing patient level benefits verifications as applicable for all major medical and pharmacy benefits plans.
- Completion of the template forms that provide patient level benefits Coverage Determination Summary.
- Coordination of prior authorizations based on payer guidelines and in compliance with law, regulation or guidance.
- Patient Assistance:
- Review of patient assistance enrollment forms and any supporting documentation to assess patient eligibility for participation as per SOPs and program guidelines.
- Determination of patient’s eligibility based upon program criteria for qualification.
- Communicating the patient’s eligibility to the patient, healthcare provider, and/or consignment pharmacy.
- Answer and assist inbound callers through resolution utilizing answers to frequently asked questions or by warm transferring callers to other appropriate individuals.
- Actively listen to each customer, assess needs, and respond with demonstrated patience and courtesy.
- Review and identification of information that is missing and/or incorrect within program service requests/program applications.
- Reporting of Adverse Events/ Product Complaint inquiries received in accordance with SOP and good manufacturer practices.
- Provides timely feedback to the company regarding service failures or customer concerns
- Effectively uses our internal technology platform, PharmaCord Lynk, to complete claims processing and keep workflows moving.
- Communicate with key medical practice accounts, sales representatives regarding the status of cases. Provide consultative services where issues arise on how obstacles can be overcome to get patient on paid therapy.
- Benefits Specialists are expected to be patient focused and committed to providing the highest quality customer service all while maintaining a sense of compliance and commitment to abiding by company policies and procedures.
This job might be for you if (must have requirements of the role):
The candidate must possess the following personal attributes:
The candidate must possess the following personal attributes:
- Service minded; focus on recognizing and meeting the needs of others (especially patients and care partners)
- Ability to handle personal health information with confidentiality
- Commitment to honesty and integrity
- Professionalism and a strong sense of proper business and customer service etiquette
- Clear verbal and written communication skills
- Accountability for results
- Ability to plan and prioritize tasks and strong attention to detail
- Proficient emotional intelligence (ability to recognize emotions and their effects)
- Ability to manage disruptive impulses and handle potentially stressful customer interactions
- Proficient computer skills
- Adaptability to change
- Personal initiative and commitment to team and organizational goals
- Ability to work effectively within a team
- A positive attitude!
Requirements:
- Bachelor's degree strongly preferred or equivalent experience required; completion of a high school diploma or GED is required
- 6 months customer service experience, payer benefits experience (reimbursement, prior authorization, etc.), healthcare industry experience or healthcare related certification, license, or equivalent coursework is strongly preferred
- Bilingual is a plus
- This is an office-based position, the ability to sit for extended periods of time is necessary
- Although very minimal, flexibility to travel as needed is preferred
- We are located in Jeffersonville, IN. You must be willing to work in this location; PharmaCord does reimburse for tolls if applicable, at the frequent user rate. This rate is applied after 40 trips per month (valued at $678.60 per year).
Physical Demands & Work Environment:
- While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit for long periods of time, use hands to type, handle or feel; and reach with hands and arms. Must be able to type 35 WPM with 97% accuracy.
- Although very minimal, flexibility to travel as needed is preferred.
- This position requires ability to work a standard 8.5-hour standard shifts between our business operating hours of 8am - 8pm Monday through Friday. A shift will be assigned and may change depending on business need.
- This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc.
- Due to investment in program specific training, candidates are expected to maintain role for a minimum of 6 months, or within a client-facing role, prior to being considered eligible for lateral or promotion level move. PharmaCord is committed to creating a strong company culture that values collaboration, employee development, and promotion from within. Exceptions will be reviewed on a case-by-case basis to assess business need and service impact.
Once you land this position, you’ll get to enjoy:
Our Benefits & Perks
- Company paid Short-term Disability (STD)
- Increased competitive 401(k) company match up to 4%
- Affordable Medical, Dental, and Vision benefits - PharmaCord covers 75% of Medical Premiums for our employees
- Wellness discounts of up to $260 per year for participation in wellness program
- Annual HSA employer contribution
- Company paid and voluntary Life Insurance options
- Voluntary Life, AD&D and Long-Term Disability Insurances
- Paid Parental Leave of Absence
- Wellness and Employee Assistance Programs
- PTO benefits, flex days and paid holidays
- Employee Referral Program
- Ambassador Program
- Tuition reimbursement program up to $5,000 per year
Competitive Compensation & Flexible Working
- Competitive starting pay rates
- Toll reimbursement program (valued at $678.60 per year)
- This role may be eligible for a hybrid schedule (50% in office, 50% remote). To qualify for a hybrid schedule, you are required to work a minimum of 6 months on-site at our headquarters location. You must show you've successfully completed training, are in good performance and attendance standing, and are consistently meeting KPI's as outlined within the program business rules.
- Multiple shift options between 8 AM and 11 PM Monday - Friday
A Career You'll Love
- Working for PharmaCord - voted Best Places to Work in Kentucky for 2019 and 2021
- Work for a company that values diversity and makes deliberate efforts to create in inclusive workplace
- Opportunities for advancement with a company that supports personal and professional growth
- A challenging, stimulating work environment that encourages new ideas
- Exposure to many learning and development opportunities
- Playing a crucial part in the lives of our patients, physicians, and pharmacies by enhancing the patient services experience
- Our new state of the art Headquarters building offering many amenities including collaborations spaces, outdoor dining, walking path, marketplace café, and more!
Any offer of employment is contingent on completion of a background check to company standard. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
At PharmaCord, we don’t just accept difference – we celebrate it, support it and we thrive on it for the benefit of our employees, our products and our community. PharmaCord is proud to be an equal opportunity employer.
PharmaCord is unable to sponsor employees at this time.
Want to learn more about us? Find us on LinkedIn, Glassdoor, Twitter & Facebook!
Salary : $260 - $5,000
