Lead Insurance Verification Coordinator

CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services.

Job Details:

Under minimal supervision, this position will oversee the Insurance Verification Team to ensure that patient referrals, insurance checks, financial responsibility letters and benefit communications are completed timely and accurately. This position creates department processes, maintains reference material, coordinates single patient agreements, generates price quotes, manages team auditing, generates reports, and provides team education as needed.

Responsibilities

• Expert knowledge in insurance verification, payor guidelines, contract pricing, test claims and authorizations.

• Assists employees with day-to-day questions, issues and complex cases.

• Identifies areas of focus to improve team efficiencies and works with Supervisor to implement necessary changes.

• Communicates both internal and external updates/process changes to the team.

• Creates and manages team reference material and documentation.

• Completes Insurance Verification Coordinator responsibilities as needed.

• Demonstrates the ability to work effectively and maintain expected productivity.

• Cooperates with other staff members when planning and organizing daily activities.

• Prioritizes and completes work on schedule.

• Meets quality standards, shows pride in performance, and demonstrates reliability and follow-through on all assigned tasks.

• Demonstrates ability to communicate effectively and express ideas clearly.

• Conduct team meetings as needed/required.

• Assist supervisor in monitoring workflow to ensure accounts are worked timely and accurately.

• Assist in interview process when recruiting new hires.

• Performs in accordance with system-wide competencies/behaviors.

• Performs other duties as assigned.

Skills & Abilities

• Excellent written and verbal communication

• Organized

• High Integrity

• Interpersonal skills

• Adaptability

• Time Management

• Conflict resolution

• Effective Problem-solving skills

Requirements

• HS diploma or GED required.

• 3+ years of insurance verification, prior authorization or other related experience in a physician

• practice, ancillary provider, or other relevant healthcare setting required.

• Knowledge of medical terminology required.

• Knowledge of payer websites, eligibility, coordination of benefits required.

• Knowledge of plan formularies and authorization requirements required.

• Knowledge of pharmacy vs medical payers and authorization required.

• Proficient computer skills and Microsoft Office Products required.

• Leadership experience preferred.

• Excellent customer service skills.

• Self-starter with the ability to work with minimum supervision.

CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country.