Pharmacy Benefit Verification Pro — Cancer Care Support

Onco360 Oncology Pharmacy; Houston (TX); On-site; USD 27,000 - 39,000; Full time

Benefits offered by this job

401k with match

Paid Time Off

Paid Holidays

Tuition Reimbursement

Floating Holiday

Referral Incentive

Paid Life Insurance

Short & long-term disability

Job summary

Onco360 Oncology Pharmacy in Houston, TX is seeking a Pharmacy Benefit Verification Specialist to verify and load patient insurance information, determine coverage, and support providers and patients. The role includes coordinating benefits and authorizations for pharmacy and medical claims, while upholding privacy and regulatory standards.

Eligibility processing, CPR+ system use, and seamless collaboration with operations will be essential in delivering timely, accurate benefit responses for

Qualifications

• 1+ years pharmacy or benefit verification experience.
• High School Diploma or GED required.
• Associate degree or PT/CB certification desired.

Responsibilities

• Investigate, review, and load accurate patient insurances.
• Perform full benefits verification for pharmacy and medical benefits.
• Run test claims to obtain valid claim responses and determine coverage.
• Coordinate authorizations and TOAs for applicable claims.
• Maintain patient confidentiality and comply with regulations.

Skills

PBM knowledge

NDC billing

Coordination of benefits

Medicare/Medicaid knowledge

Communication skills

Detail-oriented

Time management

Education

High School Diploma or GED

Associate degree or PT/CB Cert

Tools

CPR+ system

E1 check

Job description

Onco360 Oncology Pharmacy in Houston, TX is seeking a Pharmacy Benefit Verification Specialist to verify and load patient insurance information, determine coverage, and support providers and patients. The role includes coordinating benefits and authorizations for pharmacy and medical claims, while upholding privacy and regulatory standards.

Eligibility processing, CPR+ system use, and seamless collaboration with operations will be essential in delivering timely, accurate benefit responses for