Specialty Benefits Verification Specialist

ContinuumRx; Birmingham (AL); On-site; USD 42,000 - 62,000; Full time

Job summary

ContinuumRx is seeking a Verification Specialist - Specialty to verify insurance benefits and obtain authorization for specialty therapies. You will document interactions in the EMR and communicate with patients, intake, and sales to resolve issues promptly.

The role requires the ability to determine patient financial responsibility, coordinate benefits, and manage multiple tasks under time pressure with strong attention to detail.

Qualifications

• 2+ years of experience in healthcare reimbursement with a focus on insurance verification and authorizations.
• Experience in coordination of benefits (HMO, PPO, TPA, state and federal payors) is preferred.
• Prior work in specialty or home infusion or related field is preferred.
• Knowledge of specialty medications (IVIG, injections) and PA requirements.
• Exceptional communication and interpersonal skills; ability to work under pressure.

Responsibilities

• Verifies benefit coverage and financial responsibility.
• Creates Insurance Benefit Summary (IBS) documents as needed.
• Identifies out-of-pocket costs prior to services.
• Obtains prior authorization for specialty therapies.
• Documents all patient interactions in the EMR as billing notes.
• Acts as a resource for patients, Intake and Sales to resolve issues.
• Verifies insurance coverage through payor websites or by calling payors.

Skills

Insurance verification

Authorization processes

Communication

Attention to detail

Customer service

Time management

Education

High School Diploma or GED

Tools

EMR systems

Job description

ContinuumRx is seeking a Verification Specialist - Specialty to verify insurance benefits and obtain authorization for specialty therapies. You will document interactions in the EMR and communicate with patients, intake, and sales to resolve issues promptly.

The role requires the ability to determine patient financial responsibility, coordinate benefits, and manage multiple tasks under time pressure with strong attention to detail.