Hybrid Insurance Resolution Specialist (Pharmacy Claims)

PANTHERx Rare Pharmacy; Pittsburgh (Allegheny County); Hybride; USD 42 000 - 60 000; Plein temps

Avantages offerts par ce poste

Hybrid/remote work

Comprehensive benefits

401K with match

Paid time off

Paid holidays

Résumé du poste

PANTHERx Rare Pharmacy in Pittsburgh, PA is seeking an Insurance Resolution Specialist (Second Shift) to verify patient pharmacy and medical claims with precision. You will liaise between patients, insurers, and government agencies to ensure timely, accurate billing and medication delivery.

The role requires attention to detail, strong communication, and the ability to manage multiple tasks in a fast-paced healthcare environment. Hybrid work setup and comprehensive benefits are provided.

Qualifications

• High school diploma required; minimum 2 years’ experience processing pharmacy claims.
• Strong written and verbal communication skills are necessary to convey ideas professionally and effectively.
• Ability to multitask in a fast-paced environment; proficient with listed tools and systems.

Responsabilités

• Verifies all benefit information needed to process a claim under pharmacy or medical coverage.
• Processes pharmacy claims on the patient’s behalf through a pharmacy benefit system.
• Verifies medical benefits accurately on patient’s behalf.
• Obtains authorizations & overrides as needed with insurance providers.
• Processes patient information for copay cards and/or assistance programs.
• Discusses with patients a review of patient financial responsibility and obtains consent and payment.
• Ensures proper shipment setup of prescriptions.
• Supports special projects and other tasks as assigned.

Connaissances

Communication skills

Multitasking

Pharmacy claims processing

Formation

High school diploma

Outils

Cover My Meds

EDS billing systems

Excel

Word

Description du poste

PANTHERx Rare Pharmacy in Pittsburgh, PA is seeking an Insurance Resolution Specialist (Second Shift) to verify patient pharmacy and medical claims with precision. You will liaise between patients, insurers, and government agencies to ensure timely, accurate billing and medication delivery.

The role requires attention to detail, strong communication, and the ability to manage multiple tasks in a fast-paced healthcare environment. Hybrid work setup and comprehensive benefits are provided.