Fertility Benefits Navigator

Pixel Care; Cedar Knolls (NJ); On-site; USD 55,000 - 75,000; Full time

Job summary

Pixel Care is seeking an Insurance Specialist for a full-time, on-site role at our Cedar Knolls, NJ location. The role runs Monday through Friday, 9:00 am–5:30 pm, and focuses on benefits analysis, prior authorizations, and helping patients navigate insurance and access medications.

You will work across payer portals and pharmacy systems, identify coverage opportunities, and coordinate with patients, providers, and care teams to move insurance processes forward efficiently and with empathy.

Qualifications

• High School Diploma or equivalent, required.

Responsibilities

• Conduct comprehensive benefits analysis for pharmacy and medical benefits.
• Perform and manage prior authorizations and pre-certifications for prescribed medications.
• Review payer requirements to complete prior authorization requests.
• Investigate rejected pharmacy claims and resolve coverage barriers.
• Coordinate with patients, providers, clinics, pharmacists, and payers for documentation.
• Monitor authorizations to completion and follow up on pending items.
• Assist with denials and appeals with required documentation.
• Provide patients with clear information on coverage and costs.
• Reach out to patients for updates or support to access medications.
• Escalate clinical questions to pharmacists when needed.
• Collaborate with care teams to resolve complex insurance questions.
• Protect patient information and HIPAA compliance.

Skills

Insurance verification

Prior authorizations

Benefits analysis

Healthcare reimbursement

Patient access

Attention to detail

Communication

Multitasking

HIPAA compliance

Independent work

Team collaboration

MS Office

Excel

Teams

EMR systems

Payer portals

Education

High School Diploma or equivalent

PTCB Certification

Tools

EMR systems

Pharmacy platforms

Payer portals

Microsoft Office

Teams

Excel

Job description

Pixel Care is seeking an Insurance Specialist for a full-time, on-site role at our Cedar Knolls, NJ location. The role runs Monday through Friday, 9:00 am–5:30 pm, and focuses on benefits analysis, prior authorizations, and helping patients navigate insurance and access medications.

You will work across payer portals and pharmacy systems, identify coverage opportunities, and coordinate with patients, providers, and care teams to move insurance processes forward efficiently and with empathy.