Benefit Verification Specialist, Pill Club

About this role

Our Benefit Verification Team is a panel of experts on the entire insurance verification process. Their primary role is to ensure our patients’ pharmacy and medical services are processed by insurance payers in a timely manner. In this role, you will perform eligibility checks, detailed insurance verification, and act as a liaison between patients, third-party payers, and internal stakeholders. We are on a mission to simplify the process of providing our patients with access to healthcare. If you are interested in working at a rapidly growing healthcare startup and being a part of building a company that’s changing the way birth control is dispensed, please consider joining our team!

You will:

• Collect, review, and process patients’ insurance information to complete benefits investigations with speed and accuracy (eligibility and coverage for both medical and pharmacy benefits)
• Use a computer and phone on a regular basis to interact with patients, peers, Pharmacists, medical staff, and other internal experts/resources engaged in servicing our patients
• Leverage internal systems and/or contact insurance carriers via phone and website/portals to obtain verification of eligibility and coverage details
• Input detailed and confidential medical information
• Maintain proprietary databases and tools to support insurance verification
• Assist in medical billing functions and collections (e.g., enroll payers for eligibility, claims, EFTs, and ERAs; payer website enrollment; supporting medical billing phone line and voicemails, etc.)
• Report any insurance verification, roots processing, or billing trends to the broader team and consolidate issues and opportunities to report to leadership
• Lead training on our insurance verification processes for the broader organization
• Be able to effectively collaborate with peers and cross-functional teams to solve problems and enhance the insurance verification and billing processes
• Follow prescribed processes and be able and willing to identify new solutions that improve the benefits verification process within required SOPs/policies
• Identify opportunities for improvement in our insurance processing automation or manual processes
• Submit prior authorizations on behalf of the medical and pharmacy organizations
• Be flexible to work overtime, evenings, or weekends as needed
• Perform other duties as assigned

You have:

• Reliability – demonstrated ability to meet commitments including following policies, procedures, and working schedules as assigned.
• Work Standards – establishes a high bar for quality and volume of work; independently or
• with minimal guidance sets criteria that consistently meets or exceeds what is expected and/or asked.
• Patient Centricity – has a natural desire to create and deliver an exceptional experience to
• those being served (i.e. patient, customer, peer, manager)
• Great communication skills – effectively engage internal and external stakeholders and represent our Company via verbal and/or written communication; demonstrates a high comfort with speaking via text and phone
• The ability to learn quickly and adapt to changing requirements based on business, legal and medical governance
• High School Diploma or equivalent required.
• Minimum of 2 years experience in insurance verification and benefits
• Familiarity with insurance and billing policies and procedures

Even better if you have:

• Experience in patient access/ patient registration and/or billing experience in a clinical care setting
• Experience working in a start-up or healthcare environment
• College degree preferred
• Proven ability to effectively communicate succinctly both verbally and in writing; to present
• information and respond to questions from patients.
• Effective data entry; speed and accuracy critical.
• Strong interpersonal and organizational abilities.
• Basic computer skills including working knowledge with word processing

APPLY HERE