Insurance Verification Specialist

2 weeks ago


Pittsburgh, United States Medix Full time
Job Title: Insurance Verification Specialist - Pharmacy/Medications Focus

Location: Pittsburgh, PA

Job Type: Full-Time

Hours: Monday-Friday with one Saturday a month

Pay: Pending relevant years of experience - $18-20/h

Backgrounds- open to Pharmacy Technician background or strong prior authorization experience

Job Overview: As an Insurance Verification Specialist, you will play a key role in the pre-authorization process, verifying insurance coverage, and assisting patients in accessing their medications. You will work closely with pharmacies, healthcare providers, and insurance companies to navigate insurance requirements, with a strong focus on prior authorizations and medication-related processes.

Key Responsibilities:
  • Verify insurance eligibility and coverage for prescribed medications.
  • Obtain prior authorizations from insurance companies, ensuring timely and accurate completion.
  • Review and interpret insurance policies to determine benefit coverage for medications.
  • Communicate with healthcare providers, pharmacies, and insurance companies to resolve any issues with prior authorizations or coverage.
  • Maintain detailed and accurate records of patient information, insurance status, and authorizations.
  • Stay up-to-date with insurance regulations and changes in prior authorization processes.
  • Provide excellent customer service to patients, addressing any questions or concerns regarding their insurance and medication coverage.
Qualifications:
  • Minimum of 2 years of experience in insurance verification or prior authorization in a healthcare setting, preferably in a pharmacy or medication-focused environment.
  • Strong knowledge of medical and pharmacy insurance policies, procedures, and prior authorization processes.
  • Experience working with insurance companies, specifically handling medication-related claims and authorizations.
  • Exceptional communication and organizational skills with the ability to manage multiple tasks simultaneously.
  • Proficient in healthcare-related software and systems for tracking authorizations and patient information.
  • Detail-oriented, with a strong commitment to accuracy and compliance.
Preferred Qualifications:
  • Previous experience working in a pharmacy or handling prior authorizations for medications.
  • Knowledge of Medicaid, Medicare, and commercial insurance plans.
Benefits:
  • Competitive salary and comprehensive benefits package
  • Health, dental, and vision insurance
  • 401(k) with company match
  • Career development and advancement opportunities


Medix is acting as an Employment Agency in relation to this vacancy.

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