Insurance Resolution Specialist - See below for shift hours

About the role

PANTHERx is a rare disease pharmacy aiming to provide uncompromising quality in healthcare. We seek team members who are inspired, compassionate, and dedicated to patient care.

Responsibilities

• Verifies patient pharmacy and medical claims accurately and quickly.
• Liaises between patients, insurance companies, and government agencies to ensure accurate medication delivery and correct billing.
• Processes pharmacy claims through a pharmacy benefit system.
• Verifies medical benefits on behalf of patients.
• Obtains authorizations and overrides as needed in collaboration with insurance providers.
• Supports patients with reviews of financial responsibility and obtains consent and payment.
• Sets up proper shipment of prescriptions.
• Supports special projects as assigned.

Requirements

• High school diploma or GED.
• Minimum 2 years’ experience processing pharmacy claims.
• Strong written and verbal communication skills.
• Ability to multitask.
• Proficiency with Cover My Meds (CMM), EDS billing systems, Excel, and Word.

Preferred Qualifications

• Experience or knowledge within the healthcare industry, particularly in mail order or specialty pharmacy.
• Strong understanding of benefit verification/prior authorization processes.
• Experience with CPR+

Physical Demands

• Regularly sits, talks, and hears.
• Frequently stands, walks, uses hands and fingers, handles, and feels objects.
• Uses hands and arms to reach.
• Reads and works with various forms of data for extended periods on a computer screen.

Benefits

• Hybrid, remote, and flexible on-site work schedules.
• Affordable medical, dental, vision, health savings, and flexible spending accounts.
• 401K with employer matching.
• Employer-paid life insurance and short/long-term disability coverage.
• An Employee Assistance Program.
• Generous paid time off.
• Paid holidays.

Equal Opportunity

PANTHERx Rare Pharmacy is an equal opportunity employer and does not discriminate based on race, age, religion, gender, ethnicity, sexual orientation, gender identity, disability, protected veteran's status, or any other characteristic protected by federal, state, or local laws.