Pharmacy Benefits /Insurance Verification Specialist | Onsite- Pittsburgh
Core
Process pharmacy claims and triage rejected insurance claims to verify patient coverage and ensure timely access to medications.
Role type
Claims verification specialist
Builds
Patient access to critical medications via pharmacy claims processing
Domain
Healthcare / Pharmacy benefits administration
Deliverable
client delivery
Required skills
Pharmacy experience, third-party claims resolution, compliance with patient assistance programs, data documentation, research using available resources, technical aptitude for complex software
Preferred skills
Bachelor's degree, healthcare industry experience with claims background, strong verbal and written communication, attention to detail, ability to work cross-functionally
Responsibilities
Process pharmacy claims accurately and timely, Triage rejected pharmacy insurance claims to ascertain patient pharmacy benefits coverage, Maintain compliance with patient assistance program guidelines, Document all information and data discovery according to operating procedures, Research required information using available resources, Maintain confidentiality of patient and proprietary information
