Insurance Specialist II
4 weeks ago
AbbVie is seeking a highly skilled Insurance Specialist II to join our team. As a key member of our Access Support team, you will play a critical role in ensuring patients have access to our innovative medicines and solutions.
Key Responsibilities:- Act as the primary point of contact for healthcare providers and patients, addressing complex patient access challenges and providing accurate explanations of medical and/or pharmacy benefits, financial assistance, and access questions.
- Provide subject matter expertise and best-in-class customer service for all inbound and outbound customer calls, driving first call resolution and ensuring a positive service image at all times.
- Investigate and problem-solve for patients experiencing escalated issues, such as disadvantaged or complex access, savings card/copay card challenges, or non-preferred formulary issues.
- Maintain an understanding of current business procedures, deviations, and case processing for all brands and channel sources, supporting the Insurance Specialist I role as needed.
- Accurately communicate insurance details to healthcare providers and patients via phone, electronic communication methods, and fax, adhering to established policies and procedures.
- Identify potential Adverse Event situations for reporting to Pharmacovigilance, ensuring AbbVie meets FDA regulations.
- Support changing business priorities by being flexible in executing or overseeing completion of specific tasks to support patients, products, or services.
- Liaise between healthcare providers, insurance companies, AbbVie Patient Access Support field reps, Ambassadors, filling pharmacies, and patients to administer the Patient Support Service programs.
- Educate healthcare providers, AbbVie Patient Access Support field representatives, filling pharmacies, and patients on access processes specific to their patient's insurance plan.
- Meet or exceed department standards relative to performance metrics, maintaining a work environment that upholds privacy standards required by law and AbbVie policy.
- High school diploma or GED equivalent required; degree preferred.
- 2-4 years of work experience in a healthcare or reimbursement setting; previous experience in a call center environment, healthcare office, or specialty pharmacy preferred.
- Understanding and knowledge of commercial and government pharmacy and medical insurance programs, billing, alternate funding resources, reimbursement processes, prior authorization, and appeal filings, and specialty pharmacy operations preferred.
- Experience and knowledge in Medicare Part D, Medicaid, and alternate funding resources, private payers, pharmacy benefits, and medical benefits preferred.
- Demonstrated ability to lead and participate within a team, manage multiple priorities, and meet associated timelines while maintaining accuracy.
- Proven leadership skills, professional written and verbal communication skills, and ability to maintain a positive service image at all times.
- Ability to maintain a work environment that upholds privacy standards required by law and AbbVie policy.
- A comprehensive package of benefits, including paid time off, medical/dental/vision insurance, and 401(k) to eligible employees.
- A short-term incentive program.
- A commitment to operating with integrity, driving innovation, transforming lives, serving our community, and embracing diversity and inclusion.
AbbVie is an equal opportunity employer and is committed to operating with integrity, driving innovation, transforming lives, serving our community, and embracing diversity and inclusion.
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