Benefits Verif Tech

Birdirx; Plymouth, Northern (MI, KY); On-site; USD 34,000 - 42,000; Full time

Job summary

Birdirx is seeking a Benefits Verification Technician in Michigan to support members, providers, and pharmacies with prescription eligibility and prior authorization questions. You will coordinate with PBM services and maintain detailed records.

The role requires a Pharmacy Technician certification, 2+ years in a pharmacy setting, and strong communication skills to navigate high-paced environments. Office-based with standard hours and occasional extended times may apply.

Qualifications

• 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, PBM, or managed health care preferred.
• Knowledge of claims adjudication preferred; knowledge of secondary billing practices including prescription discount cards and Medicaid preferred.

Responsibilities

• Assist members, providers, and pharmacies with questions regarding eligibility and claims processing.
• Coordinate with PBM services to support patient prescription processing and provider inquiries.
• Maintain records of correspondence and actions taken, including inquiries and responses.
• Assist with training and updates within the department of technicians as needed.
• Assist customer service and other departments with various tasks, including member correspondence.
• Support coordination of routine inquiries from members, providers, pharmacies, and payers.

Skills

Verbal communication

Written communication

Interpersonal skills

Organizational skills

Time management

Attention to detail

Customer service

Team collaboration

Analytical thinking

Problem solving

Microsoft Office

Education

High School Diploma

Pharmacy Technician Certification

2+ years pharmacy experience

Undergraduate degree desirable

Tools

PBM software

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
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