Benefit Verification Technician

Location : Remote Position

Pay Range : $18.93 - $31.56

RESPONSIBILITIES :

Primary Key Performance Areas

KPA 1 - Insurance Verification

• Verify Private, Medicaid, and Medicare insurance coverages (include VA, IHS, and other unique programs).
• Complete patient facility (Hospital, Hospice, Rehab, ALF, Skilled Nursing, etc.) verifications and determine medication coverage.
• Verify patient eligibility to utilize AON Pharmacy via test claim to their pharmacy insurance.
• Refers prescriptions to our Prior Authorization or Financial Assistance teams based on test claim responses.
• Offer and enroll patients in manufacture copay cards for commercial payors to assist in covering patient financial responsibility.

KPA 2 - Specialty Pharmacy Referrals

KPA 3 - Claims Resolution

KPA 4 - Pharmacy Call Center Communication

KPA 5 - Compliance

Ensure all local, state, and federal guidelines are followed as well as corporate policies, pharmacy Standard Operating Procedures (SOPs) and accreditation bureaus' standards .

Examples of job duties include, but not limited to :

Position Qualifications / Requirements

Education : High school education, GED, or equivalent required

Certifications / Licenses : Active / Unrestrictive Pharmacy Technician permit in the state of residence. Willing to obtain Florida Technician permit (if applicable).

Previous Experience : Two years' experience in specialty, retail, mail order, or hospital pharmacy as a pharmacy technician is required.

Core Capabilities :

Analysis & Critical Thinking : Critical thinking skills including solid problem solving, analysis, decision-making, planning, time management and organizational skills. Must be detail oriented with the ability to exercise independent judgment.

Interpersonal Effectiveness : Developed interpersonal skills, emotional intelligence, diplomacy, tact, conflict management, delegation skills, and diversity awareness. Ability to work effectively with sensitive and confidential material and sometimes emotionally charged matters.

Communication Skills : Good command of the English language. Second language is an asset but not required. Effective communication skills (oral, written, presentation), is an active listener, and effectively provides balanced feedback.

Customer Service & Organizational Awareness : Strong customer focus. Ability to build an engaging culture of quality, performance effectiveness and operational excellence through best practices, strong business and political acumen, collaboration and partnerships, as well as positive employee, physician and community relations.

Self-Management : Effectively manages own time, conflicting priorities, self, stress, and professional development. Self-motivated and self-starter with ability to work independently with limited supervision. Ability to work remotely effectively as required.

Must be able to work effectively in a fast-paced, multi-site environment with demonstrated ability to juggle competing priorities and demands from a variety of stakeholders and sites.

Computer Skills :

Proficiency in MS Office Word, Excel, Power Point, and Outlook required.

Travel : 0%

Standard Core Workdays / Hours : Monday to Friday 8 : 30 AM - 5 : 00 PM local residence time. Occasional overtime may be required, and weekend shifts based on location hours and operational needs.