Benefits Verification Specialist
- Operations - (PBO) Patient Support 5250
- Green Tree, PA, USA
- Full Time
At ConnectiveRx we simplify how people get and stay on medications by providing information, savings and access. Formed in 2015 with a merger between PSKW and PDR bring industry leadership from pharma services, e-prescribing network services, retail pharmacy and commercial payers to deliver healthcare affordability and adherence solutions excellence. We work with over 150 pharmaceutical manufacturers and serve hundreds of brands at all stages of the product lifecycle.
We are looking to hire several seasoned Customer Service Specialists, preferably with Healthcare Benefits experience at our Green Tree, PA office.
These roles establish effective communication with patients and their families, physicians, third party payors as well as client pharmaceutical manufacturer representatives. This includes coordinating the care of patients to assure access to their pharmacy products and services. Maintaining a high level of quality customer service standards, in compliance with federal and statutory regulations and guidelines is essential.
• Verify insurance coverage for potential new patients and re-verify insurance coverage for existing patients in order to process patient prescription needs.
• Collect the appropriate information needed to ensure insurance coverage for patient medication orders and document in computer systems.
• Process patient prescription needs, reduce exposure to adverse events all while delivering high touch, concierge level customer service to patients, healthcare professionals and insurance carriers.
• Contact insurance carriers to resolve submission rejections and insurance coverage issues.
• Identify potential issues, collect and document or publish data, establish facts, draw conclusions and solve problems.
• Maintain a timely turnaround for insurance verifications.
Understanding of how to communicate information on health insurance, reimbursements, third party terms and medical terminology is preferred.
Knowledge of government and patient assistance programs.
Understanding of commercial insurance concepts including drug cards and major medical benefits.
Analytical and problem solving skills.
Computer and math skills are required with attention to detail and quality essential.
High school diploma or equivalent, required.
Bachelors' degree or equivalent in business, hospital administration, marketing, or related field preferred.
Minimum of 2 years of experience in customer service, insurance, benefits, marketing, sales or related area, required.
Health care environment with third party benefits verification experience, a plus.
Prior phone customer service experience with essential skills in navigating a software system to document conversations and outcomes, as well as managing follow-up actions, highly desired.
Must have effective and empathetic communication style in managing in/outbound calls and communications with clients and team members.
Approachable and dedicated to providing the highest quality of concierge level customer service.
Must possess the core values of Passion, Innovation, Integrity, Accountability
Ability to work with people in a team environment while meeting individual performance goals
A history of building constructive and effective relationships using diplomacy and tact in resolving issues as well as diffusing high-tension situations.
Providing timely information needed by others in the process and being a team player.