Hybrid Pharmacy Insurance Resolution Specialist

PANTHERx Rare Pharmacy; Robinson (PA); Hybrid; USD 40,000 - 52,000; Full time

Benefits offered by this job

Hybrid/remote work opportunities

Medical, dental, vision

401K with employer matching

Employer-paid life insurance

Short/long term disability

Employee Assistance Program

Generous paid time off

Paid holidays

Job summary

PANTHERx Rare Pharmacy in Pittsburgh, PA is seeking a dedicated Insurance Resolution Specialist (Second Shift) to verify patient insurance claims and coordinate between patients, insurers, and government agencies. This role supports accurate billing, authorization management, and timely medication delivery in a hybrid work setting.

The position requires 2+ years of pharmacy claims experience, strong communication, and familiarity with common billing systems.

Qualifications

• High school diploma or GED is required.
• Strong written and verbal communication skills are essential.
• Ability to multitask in a fast-paced healthcare environment.

Responsibilities

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

Skills

Communication skills

Multitasking

Education

High school diploma or GED

Tools

Cover My Meds (CMM)

EDS billing systems

Excel

Word

Job description

PANTHERx Rare Pharmacy in Pittsburgh, PA is seeking a dedicated Insurance Resolution Specialist (Second Shift) to verify patient insurance claims and coordinate between patients, insurers, and government agencies. This role supports accurate billing, authorization management, and timely medication delivery in a hybrid work setting.

The position requires 2+ years of pharmacy claims experience, strong communication, and familiarity with common billing systems.