Patient Benefits Verification & Authorization Specialist

Walgreens; Orlando (FL); On-site; USD 23,000 - 30,000; Full time

Job summary

Walgreens is a national retail and healthcare company seeking a qualified candidate to support patient eligibility verification, benefits coordination, and test claims processing. You will handle inbound and outbound calls with customers, physicians, patients, and third-party providers according to SOPs and under supervision.

Responsibilities include assisting in prior authorizations, loading plans, resolving PBM or Major Medical concerns, and providing education on patient assistance when

Qualifications

• High school diploma or GED required.
• Experience delivering customer service in healthcare, PBM, or call center settings.
• Clear, effective written and verbal communication needed.
• Basic PC skills and familiarity with MS Windows and MS Office.

Responsibilities

• Respond to inbound PBM and major medical insurance related calls.
• Resolve questions following SOPs and guidelines to provide best solutions.
• Request and load PBM and Major Medical plans.
• Process non-clinical PBM rejections and prior authorization issues.
• Assist physicians in prior authorization processes.
• Verifies benefits via online resources or phone and reviews guidelines for payment accuracy.
• Document interactions and actions taken with customers and plans.

Skills

Customer service

Communication

Interpersonal skills

Problem solving

Education

High School Diploma or GED

Tools

MS Windows

MS Office Suite

Job description

Walgreens is a national retail and healthcare company seeking a qualified candidate to support patient eligibility verification, benefits coordination, and test claims processing. You will handle inbound and outbound calls with customers, physicians, patients, and third-party providers according to SOPs and under supervision.

Responsibilities include assisting in prior authorizations, loading plans, resolving PBM or Major Medical concerns, and providing education on patient assistance when