Eligibility Representative

This is a fully remote position, open to applicants in Tennessee.

📋 Description

• Conduct verification of medical and pharmacy benefits by reaching out to insurance providers or utilizing provider portals.

• Enable the resolution of drug coverage challenges through cross-functional collaboration.

• Investigate and address issues to ensure the smooth onboarding of specialty patients.

• Organize services to guarantee reimbursement aspects, including deductibles, copayments, effective dates, levels of care, and authorizations.

• Execute insurance reviews on the shipment day to verify reimbursement criteria and mitigate bad debt risks.

• Work together with internal teams to resolve issues and supply necessary information.

• Address patient and intricate client complaints with discretion and independent judgment, escalating to leadership when necessary.

• Undertake additional projects and responsibilities as assigned.

⛳️ Requirements

• A high school diploma or GED is mandatory.

• A bachelor’s degree is preferred.

• A minimum of 2 years of relevant work experience is required.

• Experience in health care or a professional office setting with knowledge of medical insurance and terminology is preferred.

• Prior experience in patient access is favored.

• Experience in pharmacy or specialty pharmacy is advantageous.

• Proficiency in Microsoft Word, Outlook, and Excel is necessary.

• Outstanding written and verbal communication skills are essential.

• Capability to adapt in a fast-paced work environment and make decisions with minimal oversight.

• Strong problem-solving skills and the ability to work collaboratively with other departments are required.

• A cable broadband or fiber optic internet connection with a minimum of 10 Mbps download and 5 Mbps upload speed is required for remote work.

🏝️ Benefits

• Eligibility for an annual bonus plan.

• Medical, vision, and dental benefits available from day one.

• Programs focused on well-being and behavioral health.

• 401(k) retirement plan.

• Life insurance paid for by the company.

• Tuition reimbursement offered.

• A minimum of 18 days of paid time off each year.

• Paid holidays provided.

• Leaves of absence available.

• Opportunity for remote work arrangements.