AssistRx
Insurance Verification Specialist - Earn up to in sign on Bonus
AssistRx, Phoenix, Arizona, United States, 85003
Insurance Verification Specialist
This role works directly with healthcare providers and insurance plans/payers to gather information about a patient's insurance and the coverage provided for a specific pharmaceutical product. The Insurance Verification Specialist will support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues. This position also provides support for Prior Authorizations (PA) for an assigned caseload and helps navigate the appeals process to access medications. Responsibilities include: Ensuring cases move through the process as required in compliance with company requirements and the organization's defined standards and procedures; in a manner that provides the best level of service and quality. Conducting benefit investigations for patients by making outbound phone calls to payers to verify patient insurance benefit information, navigate complex reimbursement barriers, and seek resources to overcome the barriers. Verifying patient-specific benefits and documenting specifics including coverage, cost share, and access/provider options. Identifying any coverage restrictions and details on how to expedite patient access. Documenting and initiating prior authorization process and claims appeals. Reporting any reimbursement trends or delays in coverage to management.
This role works directly with healthcare providers and insurance plans/payers to gather information about a patient's insurance and the coverage provided for a specific pharmaceutical product. The Insurance Verification Specialist will support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues. This position also provides support for Prior Authorizations (PA) for an assigned caseload and helps navigate the appeals process to access medications. Responsibilities include: Ensuring cases move through the process as required in compliance with company requirements and the organization's defined standards and procedures; in a manner that provides the best level of service and quality. Conducting benefit investigations for patients by making outbound phone calls to payers to verify patient insurance benefit information, navigate complex reimbursement barriers, and seek resources to overcome the barriers. Verifying patient-specific benefits and documenting specifics including coverage, cost share, and access/provider options. Identifying any coverage restrictions and details on how to expedite patient access. Documenting and initiating prior authorization process and claims appeals. Reporting any reimbursement trends or delays in coverage to management.