Benefit Verification Specialist - BioPlus Specialty Pharmacy
Core
Reviewing and verifying patient insurance coverage for medical and pharmacy benefits, including loading details, running test claims, and coordinating benefits.
Role type
Benefit Verification Specialist
Builds
Accurate patient setup and claim processing for specialty pharmacy services
Domain
Healthcare / Specialty Pharmacy
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Insurance verification, claim research, system data entry, patient communication, prior authorization support, regulatory compliance
Preferred skills
Pharmacy Technician certification, specialty pharmacy experience, Medicare Parts A-D knowledge, call center experience, copay card experience
Technologies
Elevance Health systems, insurance provider portals
Responsibilities
Communicate with insurance providers and patients to confirm coverage and authorization requirements; Support prior authorizations, appeals, and financial assistance enrollment; Ensure accurate patient setup and follow up on authorization requests; Inform patients of coverage status and financial obligations; Resolve inquiries efficiently while maintaining compliance; Collaborate with pharmacy teams for timely medication access
Seniority
Entry-level, non-management