Enrollment Representative - Benefit Investigator

Representative that gathers pertinent verification of insurance benefits and prepares the appropriate documentation in adherence with company’s 2-hour brand promise. Works efficiently and provides appropriate and timely information to other departments.

Participation in all aspects of patient’s insurance verification functions in adherence to company’s 2-hour brand promise.

Responsibilities

• Responsible for accurately completing benefit investigations with adherence to company’s 2-hour brand promise
• Must be proficient in Pharmacy Benefit and Major Medical coverage including Commercial, Medicare B and Supplements, Medicare D and State Medicaid
• Responsible for a complete understanding of health insurance benefit structure including copay structure, co-insurance, deductibles, out of pocket, coordination of benefits, etc
• Adjudicate claims through Pharmacy Benefit Managers
• Ability to read and understand paid and rejected claims
• Ability to be able to read Rx and select appropriate dose/units per day supply
• Must have great customer service phone skills with the ability to use persistence and ask the right questions to obtain thorough and accurate information
• Ability to work independently and within a team setting. Must present positive attitude to create a positive work environment
• Adapt to departmental and company procedures as necessary
• Update sales staff and verification team with pertinent information
• Other Duties as assigned by Manager/Supervisor of Admissions Enrollment

Skills & Abilities

• Excellent Computer Skills
• Knowledge of medical terminology
• Excellent communication skills
• Ability to work cooperatively and be a liaison between departments when needed
• Professional image
• Ability to adhere to C.A.R.T. principles

Requirements

• High School Diploma or Equivalent
• At least 1 year of insurance verification experience
• Certified and Registered Technician preferred

BioPlus offers competitive compensation packages including health care, 401(k), growth potential, and a challenging and exciting work environment.

BioPlus is an Equal Opportunity Employer