Pharmacy Benefit Verification Specialist

4 weeks ago


Waltham, Massachusetts, United States Onco360 Full time
Pharmacy Benefit Verification Specialist Job Description

At Onco360, we are seeking a highly skilled Pharmacy Benefit Verification Specialist to join our team. As a Pharmacy Benefit Verification Specialist, you will play a critical role in ensuring accurate patient insurance information and benefit verification for our pharmacy operations.

Key Responsibilities:
  • Investigate, review, and load accurate patient insurances, including medical and pharmacy coverage.
  • Assign coordination of benefits, run test claims to obtain a valid insurance response on patient medications.
  • Investigate/identify authorization requirements needed to obtain medication coverage.
  • Enroll eligible patients in copay card assistance programs.
  • Ensure accurate benefit documentation is made for all prescription orders.

Requirements:
  • High School Diploma or GED.
  • Previous experience in pharmacy, medical billing, or benefits verification.
  • Knowledge of pharmacy insurance and benefit verification, PBM and Medical contracts, Medicare, Medicaid, and commercial insurance.
  • Pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, and pharmacy or healthcare-related knowledge.

What We Offer:
  • Starting salary at $20/HR and up.
  • Great benefits including medical, dental, vision, 401k with a match, paid time off, and paid holidays.
  • Tuition reimbursement and company-paid benefits, including life, short, and long-term disability.

How to Apply:
Interested candidates should submit their application with a cover letter and resume to [insert contact information].

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