About this opportunity
Birdirx lists this Benefits Verif Tech opportunity in plymouth, Michigan. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Th e Benefits Verif i cat ion Technician i s r es po ns i b le fo r pro v i d i ng a ssi s t an c e to members , insurance carriers, and providers with inquiries for member’s eligibility for c l aim s pro c es s i ng . Assists with questions and correspondence to find res o lu t i o n to all problems with a patient’s prescription.
Pla c e o ut bo u nd p h o n e c a l l s r e g ar d i ng ph a r m ac y pre s cr i pt i on s t o p r ov i d e r s , in s ur a n c e c a rrier s a nd p at ie nt s to ob t a in p r escr ip tio n a n d/o r b i ll i n g c la r ifi c ati o n ; fol l ow - u p a s n e e d ed fo r r e s o l uti on.
C o ntac t m e m b er s t o o bt a i n i n format ion o r t o ad v i s e o f a d el a y in o r de r pr o ces s i ng.
Co o rdin a te a dj u dic a tion supp o rt with p ha rm a cy be ne fit ma n a g eme n t (PBM) s e rvic e s.
Pr o pe r h a n d l ing o f r o ut i n e inq uir i e s fr om m e mbe r s , p r ov i d er s , p h ar m ac i e s, and p aye r s
Ma i nt a i n r ec o r d o f co r r e s p o n d e n c e , re c or di n g de t ai ls o f in q u ir i es , co m p la ints , c o mm e nt s a s w el l a s ac t i on s t ak en
C o or d i n ate wi t h p ha r ma c is t t o re s ol v e m e m be r pr e scr i pt ion is s u es a s n e e d ed.
Org a ni z e and ma i nt a i n r efe r e nc e s h eet s fo r th e t e a m as c h a n g es wi th insurance p a y er s o c cur.
Assis t w it h tr ai n i n g a nd u p d a t e s wi t h in the d e p a rtm en t o f tec h nicia n s a s n e e d ed.
Assist customer service and other departments with various tasks, includi n g member correspondence, as needed.
Assis t s u p erv i s o r wi t h u p d a t es o r c h a n g e s i n pro c es s e s a nd pro c e du r e s w i t h in th e d e p artment , i nc lu d i n g ke e p i n g up wit h c h a n g es in a d j u d ica t i on sta n da r d s a n d re q ui r e m ents.
Ach i e v e i n d iv id u al p erfor m a n c e g o a l s fo r pro duc t ivit y a nd q u a lity.
Advise supervisor(s) o f es c a l at ed is s u es.
Performs o ther duties as assigned.
Required Skills/Abilities:
Excellent verbal and written communication skills.
Excellent interpersonal and customer service skills.
Excellent o rganiz ational skills and attention to detail.
Excellent time management skills with a proven ability to meet deadlines , prioritize work and work independently .
Ab i lit y to exe r c i s e c o n s i d er a b le j ud gm e nt , m a i nta in c onfide nti a lity , and ac t i n a d i p l oma t i c ma n n er.
Ab i lit y t o collaborate wit h p e er s in a tea m effort.
Strong analytical and critical thinking skills .
Ability to function well in a high-paced and at times stressful environment.
Proficient in Microsoft Office and industry related software programs
Ability to work extended hours, weekends, and holidays in alignment with departmental and industry demands
Education / Experience:
High School Diploma required , Undergraduate degree desired or equivalent work experience.
Current Pharmacy Technician with National Certification OR Registered Pharmacy Technician Status with applicable State Board of Pharmacy
At least 2+ years in Pharmacy setting . Prior experience in Retail, Mail Order of Specialty Pharmacy, PBM, pharmaceutical or managed health care industry preferred.
Knowledge of claims adjudication preferred .
Knowledge of secondary billing practices including prescription discount cards and Medicaid preferred .
Work Enviro nment/ Physical Requirements:
Typical office environment, with minimal exposure to excessive noise or adverse environmental issues.
Prolonged periods of sitting, standing , walking, and working on a computer.
Ability to bend, reach, stoop, kneel.
Ability to utilize visual acuity to operate equipment and read technical information.
Ability to lift 15 pounds at times.
Qualifications
Education
Required
High School or better in GenEd.
Preferred
Bachelors or better in Business Administration.
Licenses & Certifications
Required
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.
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Worksite address
plymouth, MI, 48170, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.