Verifies patient insurance coverage to ensure drugs, nursing, supplies, pumps, and per diem charges are covered by an individual’s healthcare provider. Enters the patient’s insurance benefit information timely and accurately into Panther’s RxARECARE operating system. Assists the supervisor with day-to-day team questions, possess knowledge to work on multiple drugs, and assists with staffing shortages, training efforts. Works with special projects as needed. Monitors various daily reports to ensure business objectives are in line with company goals. Follows up with insurance payors, MD offices, and patients. Collects clinical information from MDO’s, hospitals, and/or facilities to initiate authorizations on behalf of the MDO or patient. Submits and obtains authorizations and payer overrides as needed for drug, nursing and per diem charges when applicable. Researches and follow ups on authorization approvals, denials, and appeals. Processes claims via NCPDP to payers. Works all rejections until payable claim is achieved. Re-verifies insurance coverage at time of shipment and ensures proper shipment set up. Assists patients with enrollments into manufacturer co-pay assistance programs or foundations. Assists patients when eligible with enrollment into Bridge and PAP programs. Abilities to work within a phone queue format for assigned drugs. Other duties as assigned within scope of job responsibilities.

Bachelor’s degree in business or related field required. Equivalent work experience may substitute education requirements. Detailed understanding of both Medical and Pharmacy insurance verification processes with all payer types. Excellent oral and written communication skills and able to communicate effectively with all levels of management. Strong problem-solving skills to evaluate all aspects of a problem or opportunity and draw valid conclusions to make appropriate and timely decisions. Knowledge of Microsoft Office Suite, especially Excel, Outlook, and PowerPoint. Knowledge of Cover My Meds a plus. Uses tact, sensitivity, sound judgement, and a professional attitude constantly. Ability to thrive working independently. 2+ years of specialty pharmacy insurance verification knowledge.