AssistRx · 11 hours ago
Benefits Verification Specialist - Specialty Pharmacy
Sand Lake, Florida, United States
Full-time
Onsite
New Grad, Entry Level
$19/hr - $23/hrAssistRx is a company focused on providing patient solutions, and they are seeking a Benefits Verification Specialist to work directly with healthcare providers and insurance plans. This role involves gathering information about patient insurance coverage and supporting the prior authorization process for medications.
Health CareInformation Technology
Responsibilities
Ensure cases move through the process as required in compliance with company requirements and the organization's defined standards and procedures; in a manner that provides the best level of service and quality
Conduct benefit investigations for patients by making outbound phone call to payers to verify patient insurance benefit information, navigate complex reimbursement barriers and seek resources to overcome the barriers
Verify patient specific benefits and document specifics including coverage, cost share and access/provider options
Identify any coverage restrictions and details on how to expedite patient access
Document and initiate prior authorization process and claims appeals
Report any reimbursement trends or delays in coverage to management
Act as a liaison for field representatives, health care providers and patients
Qualification
Required
Experience working directly with healthcare providers & insurance plans/payers
Ability to gather information about a patient's insurance and the coverage provided for a specific pharmaceutical product
Support healthcare providers addressing questions regarding coding and billing
Navigate complex reimbursement issues
Provide support for Prior Authorizations (PA) for an assigned caseload
Help navigate the appeals process to access medications
Ensure cases move through the process as required in compliance with company requirements and the organization's defined standards and procedures
Conduct benefit investigations for patients by making outbound phone calls to payers to verify patient insurance benefit information
Navigate complex reimbursement barriers and seek resources to overcome the barriers
Verify patient specific benefits and document specifics including coverage, cost share and access/provider options
Identify any coverage restrictions and details on how to expedite patient access
Document and initiate prior authorization process and claims appeals
Report any reimbursement trends or delays in coverage to management
Act as a liaison for field representatives, health care providers and patients
Onsite availability required
Company
AssistRx
AssistRx, Inc provides healthcare information technology solutions to the Specialty Pharmaceutical distribution channel.
Founded in 2009
501-1000 employees
Funding
Current Stage
Late StageTotal Funding
unknown2024-02-22Acquired
Leadership Team
Edward Hensley
Co-Founder & Chief Commercial Officer
Adam Dresen
Chief Technology Officer | CISO
Recent News
2025-09-30
Company data provided by crunchbase