Insurance Verification Specialist - Remote Oppo...

Unlock a RewardingCareer with bolthires: Insurance Verification Specialist -Remote Join the bolthires team as an Insurance Verification Specialist from the comfort of your own home in Texas. At bolthires, we're dedicated to creating more joyful lives through better health, and we're looking for talented individuals to help us achieve this mission. As a leader in the healthcare and pharmacy retail industry, we're committed to providing exceptional customer service and support to our patients and customers.About the Role As an Insurance Verification Specialist, you will play a critical role in verifying patient eligibility, coordinating benefits, and determining patient coverage and responsibility for services. You will be the primary point of contact for customers, physician offices, patients, and third-party providers, ensuring that all interactions are handled efficiently and courteously. Key Responsibilities Respond to inbound and outbound calls related to Pharmacy Benefit Manager (PBM) and major medical insurance, resolving questions and problems in accordance with established guidelines and standard operating procedures.Request and load PBM and/or Major Medical insurance plans, processing non-clinical PBM rejections and assisting physicians with prior authorizations. Verify benefits for Major Medical via online resources or over the phone, confirming network status and reviewing FDA guidelines and prior authorization requirements. Facilitate reimbursement for PBM major medical claims and identify individual customer or patient needs, providing education and support for grant applications and complex funding needs.Manage Pharma requirements, including warm transfers, bridge/quick start, enhanced prior authorization, and appeal support. Document contact interactions, recording details, complaints, comments, and actions taken. Essential Qualifications To be successful in this role, you will need: A high school diploma or GED. Experience providing customer service to internal and external customers in a healthcare, specialty pharmacy, PBM, or call center setting. The ability to communicate clearly and effectively, both written and verbally, with good interpersonal skills and a diplomatic and confidential manner.Basic level PC skills, including MS Windows and MS Office Suite, with the ability to start up and shut down computer, use mouse to point and click, start and close programs, switch between programs, save files, print documents, and access information online. Preferred Qualifications While not required, the following qualifications are highly desirable: Experience with customer service related to adherence, complex disease states, quality, After Call Work (ACW), etc. Experience in identifying operational issues and recommending and implementing strategies to resolve problems.Intermediate level PC skills, including MS Windows and MS Office Suite, with advanced skills in using software programs and accessing information online. What We Offer As a bolthires team member, you can expect: A competitive hourly rate between $15.00 to $20.00, depending on experience, seniority, geographic location, and other factors permitted by law. A comprehensive benefits package, including medical, dental, and vision coverage, 401(k) matching, and employee discounts. Opportunities for career growth and development, with training and support to help you succeed in your role.A flexible, remote work arrangement, allowing you to work from the comfort of your own home in Texas. Company Culture and Work Environment At bolthires, we're committed to creating a work environment that is inclusive, supportive, and empowering. We value diversity and believe that a diverse workforce is essential to delivering exceptional customer service and support. As a remote team member, you will be part of a dynamic and collaborative team, with opportunities to connect with colleagues and leaders through virtual meetings and training sessions.Career Growth and Development As an Insurance Verification Specialist, you will have opportunities to develop your skills and expertise, with training and support to help you succeed in your role. You will also have the opportunity to advance your career within bolthires, with opportunities for promotion and professional growth. ! If you're a motivated and detail-oriented individual with excellent customer service skills, we encourage you to apply for this exciting opportunity. As an Insurance Verification Specialist with bolthires, you will play a critical role in supporting our customers and patients, while developing your skills and expertise in a dynamic and growing industry.and take the first step towards a rewarding and fulfilling career with bolthires! bolthires is an Equal Opportunity Employer, including disability/veterans. We are committed to creating a diverse and inclusive work environment, and we welcome applications from qualified candidates.