: Customer Service and Inside Sales, Customer Service Call Center, insurance knowledge
: 100% Remote
, 100% Remote
: 3 Months
The primary function of the Insurance Analyst II is to provides best-in-class customer services to patients, Health Care Providers (HCPs) and their staff through referral and call management by investigating patients’ insurance benefits and financial assistance opportunities, in addition to processing and monitoring prior authorizations to assist the patient in starting or continuing therapy.
This position will be a subject matter expert in insurance billing, claims processing, and prior authorizations. This position liaises between departments, payers, and providers to comprehensively determine patients’ overall prescription coverage.
The Insurance Analyst II handles patient requests received by phone or electronically (fax, Humira Complete Pro, or other systems) and would complete related outbound calls.
This position works collaboratively with other areas of the Pharmacy to maximize patients’ access to care.
High school diploma or GED equivalent required. Degree preferred.
2-5 years of work experience in a healthcare or reimbursement setting; call center preferred. Previous experience in a call center environment, healthcare office, corporate setting, or healthcare insurance provider of pharmacy is highly desirable.
Must have thorough understanding and knowledge of commercial and government pharmacy and medical insurance programs, billing, alternate funding resources, reimbursement processes, prior authorization and appeal filings, and specialty pharmacy operations.
Demonstrated ability to lead and participate within a team, manage multiple priorities and meet associated timelines while maintaining accuracy.
Demonstrated strong, accurate technical skills. Must be detail oriented. Professional written and verbal communication skills required. Ability to maintain a positive service image at all times even when dealing with challenging issues and unsatisfied customers.
Proven organizational and problem solving skills, elevating to management when appropriate.
Skilled with the use of the Microsoft Office suite and the ability to use and effectively learn and navigate other computer systems
: 2-5 years
: Mir Kumail Abbas
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