Pharmacy Medical Insurance Specialist

Northborough, MA | Direct Hire

Post Date: 09/06/2017 Job ID: 79391 Specialty: Office Services

Our client in Northborough, MA is seeking a Pharmacy Medical Insurance Specialist to join their team. In this contract-to-hire role, you will be responsible for contacting insurance companies to obtain correct eligibility information, perform benefit investigations and check prior authorization and/or appeal status. As the Pharmacy Medical Insurance Specialist, you will also assist patients with copay assistance enrollment process and answering patient insurance related questions. Apply today!

Responsibilities for the Pharmacy Medical Insurance Specialist:
  • Answer in-bound calls and assisting customers with pharmacy related services
  • Utilize headset and computer terminal and navigate through multiple systems to input and retrieve information
  • Obtain client information by answering telephone calls; interviewing clients; verify information
  • Contact insurance companies for benefit investigation and coverage eligibility
  • Correct and resubmit rejected Third Party claims according to individual insurance plan requirements in an efficient manner to receive payment
  • Complete prior authorizations with attention to detail and accuracy, to then have the prepared prior authorization reviewed by a clinical pharmacist
  • Assist patients with the enrollment process for manufacturer and non-profit organization copay assistance programs
  • Provide customers with courteous, friendly, fast and efficient service
  • Contact patients to schedule medication deliveries and verify correct address information
  • Update job knowledge by participating in educational opportunities and training activities
  • Work efficiently both individually and within a team to accomplish required tasks
  • Maintain and improve quality results by adhering to standards and guidelines and recommending improved procedures
Requirements for the Pharmacy Medical Insurance Specialist:
  • Active RPhT MA and/or CPhT National pharmacy technician certification
  • Active related medical office administration certification
  • High School Diploma or equivalent. Some college preferred
  • Bilingual (Spanish) highly desirable
  • Minimum one year of experience in a health care setting, insurance adjudication or relevant work experience
  • Previous data entry experience (minimum three months) and ability to type 30wpm+
  • Working knowledge of inventory processes
  • Knowledge and ability to use Internet, MS Word and Excel
  • Working knowledge of insurance types, terminology and processes
  • Flexible work schedule preferred
  • Technology savvy with a strong knowledge working with Microsoft Office
  • Strong organizational skills with great attention to detail
  • Strong multi-tasking and prioritizing skills with the ability to meet deadlines
  • Excellent written and verbal communication skills
  • Strong interpersonal skills with a customer service focus
  • Ability to work independently and as part of a team
  • Must be eligible to work in the U.S. without sponsorship                      

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