Fertility Insurance & Benefits Specialist

Pixel Care; Hanover Township (IL); On-site; USD 39,000 - 58,000; Full time

Job summary

Pixel is seeking an Insurance Specialist to join our Cedar Knolls, NJ team in a full-time, on-site role. You will navigate insurance benefits, manage prior authorizations, and help patients access prescribed medications with empathy and accuracy.

You will collaborate with pharmacists, providers, and care teams, review payer requirements, and identify patient financial assistance opportunities while maintaining HIPAA compliance.

Qualifications

• High School Diploma or equivalent required.
• Active NJ Pharmacy Technician registration required.
• Experience with prior authorizations and benefits verification.
• Strong knowledge of insurance processes and HIPAA compliance.
• Proficiency with Microsoft Office and Excel.

Responsibilities

• Conduct comprehensive benefits analysis for pharmacy and medical plans.
• Perform and manage prior authorizations and pre-certifications.
• Review payer requirements to complete authorization requests.
• Investigate rejected pharmacy claims and identify coverage barriers.
• Identify and verify available patient financial assistance programs.
• Coordinate with patients, providers, pharmacists, and payer representatives.
• Maintain accurate documentation of benefits findings and authorization activity.
• Escalate complex insurance questions to a licensed clinician when needed.
• Protect patient information and ensure HIPAA compliance.

Skills

Attention to detail

Organizational skills

Empathy & patient communication

HIPAA knowledge

Problem solving

Education

High School Diploma or equivalent

Active NJ Pharmacy Technician Registration

Tools

Microsoft Office

Excel

EMR systems

Payer portals

Job description

Pixel is seeking an Insurance Specialist to join our Cedar Knolls, NJ team in a full-time, on-site role. You will navigate insurance benefits, manage prior authorizations, and help patients access prescribed medications with empathy and accuracy.

You will collaborate with pharmacists, providers, and care teams, review payer requirements, and identify patient financial assistance opportunities while maintaining HIPAA compliance.