Pharmacy Benefit Verification Specialist

Elevance Health; Town of Florida (NY); Hybrid; USD 40,000 - 64,000; Full time

Job summary

Elevance Health is seeking a Benefit Verification Specialist for BioPlus Specialty Pharmacy. The role focuses on reviewing and documenting patient insurance for medical and pharmacy benefits, loading details, coordinating benefits, and testing claims to confirm coverage and reimbursement outcomes.

You will collaborate with healthcare teams, providers, and patients to confirm coverage, copays, deductibles, and authorization requirements, while supporting prior authorizations and enrollment in

Qualifications

• Requires HS Diploma or GED and 1 year of pharmacy or insurance verification experience.
• Experience with Medicare Parts A–D and specialty pharmacy is preferred.

Responsibilities

• Review, verify, and document patient insurance coverage for medical and pharmacy benefits.
• Load insurance details and coordinate benefits to test claims for coverage.
• Support prior authorizations, appeals, and enrollment in financial assistance programs.
• Ensure accurate patient setup in the system and monitor referrals and authorizations.
• Inform patients of coverage status, obligations, and next steps.
• Collaborate with pharmacy teams and providers to ensure timely access and proper claim processing.

Skills

Pharmacy Tech License

Insurance Verification

Call Center

Medicare Knowledge

Medical Claims Research

Copay Expertise

Education

HS Diploma or GED

Job description

Elevance Health is seeking a Benefit Verification Specialist for BioPlus Specialty Pharmacy. The role focuses on reviewing and documenting patient insurance for medical and pharmacy benefits, loading details, coordinating benefits, and testing claims to confirm coverage and reimbursement outcomes.

You will collaborate with healthcare teams, providers, and patients to confirm coverage, copays, deductibles, and authorization requirements, while supporting prior authorizations and enrollment in