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Healthcare Insurance Analyst

A-Line Staffing Solutions

Healthcare Insurance Analyst

North Chicago, IL
Full Time
Paid
  • Responsibilities

    Job Description

    FULL TIME PHARMACY INSURANCE ANALYST OPENINGS IN WAUKEGAN, IL AREA WITH A MAJOR HEALTHCARE COMPANY! STARTING ASAP!! APPLY NOW TO MELISSA ORTIZ WITH A-LINE! MORTIZ@ALINESTAFFING.COM

     

    SUMMARY: The primary function 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.

     

    PAY RATE: $17 per hour

    SHIFT HOURS: Paid training 8am-4:30pm. Monday to Friday. Once training is completed they will be assigned one of the following shifts: 7am-3:30pm, 8am-4:30pm, 9am-5:30pm, 10:30am-7pm. Will likely be assigned late shift after training. NO WEEKENDS.

     

    RESPONSIBILITIES:

    • Provide subject matter expertise on medical and prescription insurance coverage/ verification, claim billing, medication prior authorization and appeal filing, and alternate financial assistance opportunities.
    • Accurately documents information in the appropriate systems and formats.
    • Communicate the status of the referral to the physician and the patient via phone, fax, and/or the core pharmacy system as per established policies and procedures.
    • Assist offices through the entire documentation and filing process for prior authorizations and appeals.
    • Use internal and web tools and communicate and collaborate with health insurance payers and providers to investigate pharmacy and medical benefits.
    • Obtain and confirm information to maintain Pharmacy Solutions’ payor intelligence resources.
    • Determine whether to escalate issues/concerns to management for review, guidance, and resolution.
    • Enter patient demographic and health insurance information into the hub information system and notify the physician of any incomplete or incorrect insurance information

     

    QUALIFICATIONS:

    • 3+ years of work experience in a healthcare reimbursement setting.
    • Previous experience in a call center environment, healthcare office, healthcare insurance provider or pharmacy.
    • 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.

     

    WHY APPLY:

    • FULL BENEFITS AVAILABLE AFTER 90 DAYS: Medical, Dental, Vision, Life, Short-term Disability
    • 401K AFTER 1 YEAR OF EMPLOYMENT: With employer match and profit sharing
    • GREAT HOURS! Monday through Friday, 40 hours per week, No Weekends
    • COMPETITIVE PAY RATE!

    Keywords: Medical Claims, Medical Coding, Rx Benefits, Pharmacy Benefits, Rx Authorizations, Provider Enrollment, Data Entry, Healthcare, Admin Assistant, Call Center, Mail Order Medications, Insurance Verification, Pharmacy, Prior Authorization Reimbursement Counselor, Medical Customer Service, Inbound Calls, Outbound Calls.