Search Jobs

     


Contract: Insurance Analyst / US

This job has expired or may no longer be taking applications, but other similar jobs are available.
 Click here to shortlist this job 1-CLICK Apply With Employer or Register Now
Added:2021-04-14
Location: Waukegan, Illinois, US
Salary:Up to GBP15 per annum
Duration:Contract, Temporary
Apjid3

Purpose:

The primary function of the Insurance Analyst is to provides best-in-class customer services to patients, Health Care Providers (HCPs) and their staff through referral and call management by investigating patients' insurance benefits and financial assistance opportunities, in addition to processing and monitoring prior authorizations to assist the patient in starting or continuing therapy. This position will be a subject matter expert in insurance billing, claims processing, and prior authorizations. This position liaises between departments, payors, and providers to comprehensively determine patients' overall prescription coverage. The Insurance Analyst handles patient requests received by phone or electronically (fax, Humira Complete Pro, or other systems) and would complete related outbound calls. This position works collaboratively with other areas of the Pharmacy to maximize patients' access to care.

Responsibilities:
*Provide subject matter expertise on medical and prescription insurance coverage/ verification, claim billing, medication prior authorization and appeal filing, and alternate financial assistance opportunities. Accurately documents information in the appropriate systems and formats. Communicate the status of the referral to the physician and the patient via phone, fax, and/or the core pharmacy system as per established policies and procedures.

*Assist offices through the entire documentation and filing process for prior authorizations and appeals. Monitor the status to ensure a rapid turnaround resulting in procurement of the drug product for the patient.

*Use internal and web tools and communicate and collaborate with health insurance payors and providers to investigate pharmacy and medical benefits. Obtain and confirm information to maintain Pharmacy Solutions' payor intelligence resources.

* Meet or exceed department standards relative to performance metrics. Take responsibility and accountability for the day-to-day execution of tasks and is responsible for providing periodic progress reports on goals and metrics. Work cross- functionally to identify and share opportunities for process and productivity improvement and to troubleshoot and/or resolve situations, taking ownership as needed.

*Decide whether to reinvestigate or accept obtained benefit verification based on reasonableness and accuracy. Determine whether to escalate issues/concerns to management for review, guidance, and resolution. Participate in quality monitoring and in identifying and reporting quality issues.

* Enter patient demographic and health insurance information into the hub information system and notify the physician of any incomplete or incorrect insurance information

*Understand and comply with all required training, including adherence to federal, state, and local pharmacy laws, HIPAA policies and guidelines, and the policies and procedures of Pharmacy Solutions and AbbVie.

* Identifies potential Adverse Event situations for reporting to Pharmacovigilance ensuring FDA regulations are met.

*Completes all required training and performs all functions in the position e.g., Soft Skills certification, product and disease overviews. Perform additional tasks, activities, and projects as deemed necessary by management.


How to Apply









Latest Jobs - contract: senior technician production o3contract: instrument and control engineercontract: manufacturing associate - nightsproject manager - developmentscontract: scrum mastercontract: senior software test engineerenvironmental health and safety specialistqhse specialistsenior hydrogeologistgeotechnical engineercontract: e-commerce order management supportconstruction manager (degree qualified)contract: pipeline / welding superintendentcontract: systems engineerhuman resources business partneremployee relations manager - remote opportunitycontract: technical engineering engineercontract: buyer/plannerstaff accountantsurface integrity managerassociate technician production operations i (o1)senior recruitment consultantcontract: facilities decommissioning managerlearn arabiccontract: localization project coordinator - p2civil engineerit project managercontract: quality inspector icontract: production operations technician (t1)offshore hse advisor/medicqa/qc inspectorcontract: production techniciancontract: test technician iimedical reviewerproject managercontract: manufacturing engineerpharmacy techniciancontract: senior instrument commissioning technicianassociate customer financesr. manufacturing engineercontract: sr. formulation technician (t3)contract: software support engineer - remotefield operatorhealth manager (qualified doctor)lims specialistplanning & performance analystcontract: lead pipeline engineercontract: reservoir engineercontract: surf engineering managermachine shop inspectorwelder
V
© All rights reserved, 2001 - 2021