What are the responsibilities and job description for the Insurance Specialist position at SSi People?
What you will do:
- Makes outbound calls to Payers and Pharmacy Benefit Manager in order to verify patient insurance coverage and identify available Medical and Pharmacy benefits
- Communicates case details to appropriate internal or external parties once benefit verification is complete
- Identify any payer coverage restrictions and potential mechanisms for quickly accessing therapy
- Ability to effectively contribute alone or in small work groups
- Effectively meets production and time completion goals
- Accurately document payer Prior Authorization and Appeals protocols
- Participate in special projects and perform additional duties as required
- Maintain repository of payer or brand specific coverage information
- Participate in training and process improvement initiatives
Skills
- Minimum of 2 years’ experience in customer service, insurance, benefits, marketing, sales, or related area, required, or Bachelor’s degree and 1 year of relevant experience
- Health care environment with third party benefits verification experience preferred.
- Understanding of commercial insurance concepts including coverage policies, major medical benefits, knowledge of government and patient assistance program, knowledge of and understanding of how to communicate information on health insurance, reimbursements, third party terms and medical terminology is preferred
- Ability to write routine reports and correspondence using computer applications. Excellent verbal skills and knowledge of medical terms.
- Ability to work efficiently in Microsoft Office, including the creation of spreadsheets in Excel and the ability to take notes via computer keyboard during telephone conversations.
- Focus on fundamental analytic and problem-solving skills.
- Strong professional customer services experience
Education:
- High school diploma or equivalent, required. Bachelor’s degree preferred
Salary : $18 - $20
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