Remote Pharmacy Benefit Verification Specialist

Zangmeister Cancer Center; United States; Remote; USD 22,000 - 42,000; Full time

Job summary

Zangmeister Cancer Center is seeking a Benefit Verification Technician for a remote role in the United States. You will verify insurance coverages, determine medication eligibility, and guide patients through copay programs and referrals.

You will interact with prescribing teams, manage referrals in EMR, and resolve coverage and claim issues while maintaining compliance with HIPAA and SOPs. Strong communication and problem-solving skills are essential across a multi-site, fast-paced setting.

Qualifications

• High attention to detail and accuracy.
• Strong problem solving and analytical skills.
• Excellent communication and customer service abilities.
• Ability to work independently and remotely.
• Effective time management in a fast-paced environment.

Responsibilities

• Verify Private, Medicaid, and Medicare insurance coverages (including VA, IHS).
• Complete patient facility verifications and determine medication coverage.
• Verify patient eligibility to utilize AON Pharmacy via test claim.
• Refer prescriptions to Prior Authorization or Financial Assistance teams.
• Enroll patients in manufacturer copay cards for commercial payors.
• Determine network coverage for specialty oncology and hematology medications.
• Inform patients of prescription referrals and notify nursing staff.
• Document referrals in the EMR system to alert physicians.
• Obtain Limited Distribution Overrides for AON Pharmacy to fill.
• Educate patients on financial responsibility and plan limits.
• Resolve COB coverage issues with payors and adjudicate claims.
• Resolve claim submission issues with outside pharmacies.
• Ensure effective communication with internal/external customers.
• Act as liaison between teams and review emails for timely responses.
• Ensure HIPAA compliance and adherence to SOPs and accreditation standards.

Job description

Zangmeister Cancer Center is seeking a Benefit Verification Technician for a remote role in the United States. You will verify insurance coverages, determine medication eligibility, and guide patients through copay programs and referrals.

You will interact with prescribing teams, manage referrals in EMR, and resolve coverage and claim issues while maintaining compliance with HIPAA and SOPs. Strong communication and problem-solving skills are essential across a multi-site, fast-paced setting.