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.

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

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

• Coordinate services to guarantee reimbursement, encompassing deductibles, copayments, effective dates, levels of care, and authorizations.

• Assess insurance on the day of shipment to confirm reimbursement criteria and minimize the risk of bad debt.

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

• Manage patient or complex client complaints with discretion and independent judgment, escalating when necessary.

• Complete additional projects and tasks as assigned.

⛳️ Requirements

• A high school diploma or GED is mandatory.

• A bachelor's degree is preferred.

• Minimum of 2 years of relevant work experience.

• Experience in a healthcare or professional office setting is preferred.

• Familiarity with medical insurance and terminology is preferred.

• Experience in patient access is advantageous.

• Background in pharmacy or specialty pharmacy is a plus.

• Proficient in Microsoft Office applications, including Word, Outlook, and Excel.

• Strong written and verbal communication skills.

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

• Effective problem-solving abilities.

• Ability to work collaboratively with other departments to address issues with innovative solutions.

• Access to cable broadband or fiber optic internet service with a minimum of 10 Mbps download and 5 Mbps upload speed when working from home.

🏝️ Benefits

• Eligibility for an annual bonus plan.

• Medical insurance coverage.

• Vision insurance benefits.

• Dental insurance options.

• Access to well-being and behavioral health programs.

• 401(k) retirement plan.

• Company-sponsored life insurance.

• Tuition reimbursement program.

• At least 18 days of paid time off annually.

• Paid holidays.

• Leaves of absence available.

• Remote work arrangements (either occasionally or permanently).