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Are you passionate about ensuring patients receive timely and accurate medication while navigating the complexities of insurance and healthcare systems? We’re looking for a dedicated Claim Analyst to join our team. In this role, you’ll play a pivotal part in verifying patient pharmacy and medical claims with precision and efficiency. Acting as a liaison between patients, insurance companies, and government agencies, you’ll ensure seamless billing processes and the timely provision of medication to those in need.
Responsibilities
Verify patient pharmacy and medical coverage and process information accurately.
Process pharmacy claims on behalf of patients through a pharmacy benefit system.
Accurately verify medical benefits on behalf of patients.
Obtain necessary authorizations and overrides as required.
Assist patients in applying for copay cards and/or assistance programs.
Engage with patients to review their financial responsibilities, obtain consent, and facilitate payment.
Ensure proper shipment setup for medications.
Contribute to and manage special projects as assigned.
Attend and actively participate in staff meetings.
Undertake additional tasks as delegated.
Required Qualifications
High school diploma or general education degree (GED).
Minimum Of 2 Years’ Experience In Processing Pharmacy Claims.
Strong written and verbal communication skills essential for professional and effective interactions.
Ability to multitask efficiently.
Proficiency in EDS billing systems, Excel, and Word.
Preferred Qualifications
Experience or knowledge within the healthcare industry, particularly in a mail-order or specialty pharmacy.
Familiarity with CPR+ software.
Work Environment
Our company fosters a flexible work environment, allowing eligible employees the option to work in a hybrid or remote setting without compromising performance, productivity, or team collaboration. This role primarily utilizes standard office equipment such as computers and phones.
Physical Demands
While performing the duties of this job, the employee will regularly communicate verbally, listen attentively, and utilize vision. They will frequently sit, stand, and walk, using hands and fingers for tasks, reaching, and viewing computer screens. Reasonable accommodations will be provided for individuals with disabilities to perform essential job functions.
Benefits
We offer eligible employees the flexibility of hybrid, remote, or on-site work schedules tailored to the role. Additionally, we provide an excellent benefits package, including medical, dental, and vision coverage, health savings and flexible spending accounts, 401K with employer matching, employer-paid life insurance, short/long-term disability coverage, and access to an Employee Assistance Program. Generous paid time off is available for full-time employees, with limited paid time off for part-time staff. Paid holidays are also included!
Employment Type: Full-Time
