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Accentuate Staffing is currently recruiting for a Patient Benefits Specialists to join an established company in the health care industry. This position will be Monday-Friday from 11am-8pm and is responsible for performing the appropriate processes to verify patient eligibility, coordinate benefits, determine patient coverage/responsibility for services and facilitate and eliminate insurance authorization barriers in accordance with company policies and procedures.
• Confirming the accuracy of patient insurance information from the patient’s profile in order to complete the insurance verification process
• Utilize all available resources to obtain insurance coverage information for ordered services
• Communicate with providers regarding patient updates and document in the Management Information System so that team members can quickly assess the status of the patient’s referral
• Communicate, when applicable, with patients regarding their pharmacy benefit coverage and out of pocket responsibilities
• Verify patient insurance coverage for specific product regimens to ensure accurate payment information is communicated and correct payment is collected from patients
• Facilitate prior authorization with insurance companies for customer receiving same day shipments
• Manage inbound calls on the insurance line from patients, clients, physicians, practitioners and clinics regarding inquiries about services provided, financial responsibility and insurance coverage to ensure they receive outrageous customer service
• Scans verification of patient eligibility, benefits and out-of-pocket expenses
• Provide team support of other Managed Care issues including but not limited to research of carrier allowable
• Communicate and train employees regarding updates and changes regarding Managed Care Coverage
• Coordinates with the Patient Assistance Services team to facilitate patient copay assistance and/or manufacturer assistance
• Identify and report adverse events (AEs) and product complaints (PCs) to clinicians to eliminate team members having to place additional phone calls to patients
• High School Diploma required
• Healthcare experience preferred
• Prefer at least 1+ years of experience working and understanding Insurance Verification/Benefits
• Prior experience working in a Pharmacy setting preferred