Insurance Verification Specialist - Remote Opportunity in Pennsylvania with Walgreens
Transform Your Career with a Leading Healthcare Company
At Walgreens, we're not just a pharmacy - we're a community hub dedicated to providing exceptional healthcare services and creating more joyful lives through better health. As part of the Walgreens Boots Alliance, Inc. (Nasdaq: WBA), we're proud to be a neighborhood health destination serving nearly 10 million customers each day. If you're passionate about delivering outstanding customer service and are looking for a remote career opportunity, we have an exciting role for you as an Insurance Verification Specialist.
Job Summary
We're seeking a highly skilled and experienced Insurance Verification Specialist to join our remote team based in Pennsylvania. As a key member of our team, you'll be responsible for verifying patient eligibility, coordinating benefits, and determining patient coverage and responsibility for services. You'll work closely with customers, physician offices, patients, and third-party providers to provide efficient and courteous service, ensuring seamless interactions and resolving complex issues.
Key Responsibilities
- Respond to inbound and outbound calls related to Pharmacy Benefit Manager (PBM) and major medical insurance, providing timely and effective solutions to customer inquiries.
- Resolve questions and problems submitted by customers and PBMs, following established guidelines and standard operating procedures (SOPs).
- Request and load PBM and/or Major Medical insurance plans, ensuring accurate and up-to-date information.
- Process non-clinical PBM rejections, including rejections for plan limits, coverage termed, or prior authorization.
- Assist physicians in the prior authorization process, including initiation of prior authorizations.
- Verify benefits for Major Medical via online resources or over the phone, confirming network status, reviewing FDA guidelines, and prior authorization requirements.
- Facilitate reimbursement windshields for PBM major medical claims, ensuring timely and accurate processing.
- Identify and assess individual customer or patient needs, providing education on or assisting with grant applications, complex funding needs, and commercial copay assistance enrollment.
- Provide primary support and expertise for specialized programs, such as patient assistance programs or special handling.
- 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.
About Us
Walgreens is a leading healthcare company with a rich history of caring for communities. As part of the Walgreens Boots Alliance, Inc., we're committed to creating more joyful lives through better health. Our company culture is built on a foundation of integrity, compassion, and innovation, and we're dedicated to providing a work environment that is inclusive, supportive, and empowering.
What We Offer
As a Walgreens team member, you'll enjoy a comprehensive benefits package, including competitive pay, opportunities for career growth and development, and a dynamic work environment that is both challenging and rewarding. Our benefits include:
- Competitive hourly rate between $15.00 to $20.00, depending on experience and seniority.
- Opportunities for career advancement and professional growth.
- Comprehensive training and development programs to enhance your skills and knowledge.
- A dynamic and supportive work environment that is inclusive and empowering.
- A range of benefits, including medical, dental, and vision coverage, 401(k) matching, and employee assistance programs.
Essential Qualifications
To be successful in this role, you'll need:
- A high school diploma or equivalent.
- Experience providing customer service to internal and external customers in a healthcare, specialty pharmacy, PBM, or call center setting.
- Excellent communication and interpersonal skills, with the ability to communicate clearly and effectively in a diplomatic and confidential manner.
- Basic level PC skills, including MS Windows, MS Office Suite, and/or other similar operating/software programs.
Preferred Qualifications
While not required, the following qualifications are highly desirable:
- Experience with providing 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, MS Office Suite, and/or other similar operating/software programs.
Career Growth and Development
At Walgreens, we're committed to helping our team members grow and develop in their careers. As an Insurance Verification Specialist, you'll have opportunities to:
- Develop your skills and knowledge in insurance verification, customer service, and healthcare operations.
- Take on new challenges and responsibilities, including leadership roles or specialized projects.
- Participate in training and development programs to enhance your skills and stay up-to-date with industry trends and best practices.
Work Environment and Culture
As a remote team member, you'll enjoy the flexibility and autonomy of working from home, while still being part of a dynamic and supportive team. Our company culture is built on a foundation of integrity, compassion, and innovation, and we're committed to providing a work environment that is inclusive and empowering.
Compensation and Benefits
We're committed to providing a comprehensive benefits package that rewards our team members for their hard work and dedication. While the actual salary will depend on experience, seniority, geographic location, and other factors permitted by law, we're confident that our compensation and benefits package will meet your needs.
Join Our Team
If you're a motivated and experienced professional looking for a challenging and rewarding career opportunity, we encourage you to apply for this exciting role as an Insurance Verification Specialist. As a Walgreens team member, you'll be part of a dynamic and supportive team dedicated to creating more joyful lives through better health. Don't miss this opportunity to transform your career and join our team - apply today!