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Benefits Verification- Buffalo Grove, IL
Start Date: 10/22
Training: 2 weeks 8 - 4:30pm
Shift: after 9am Mon-Fri and/ 8-3 on Sat.
A BV investigates the benefit coverage for patients needing ongoing specialty medications. Must be comfortable with handling multiple computer systems, speak to patients, Dr offices and Insurance companies! On average a BV will handle 10-15 patient transactions a day. It’s not a fast call pace where they deal with 80+ people like the call center reps.
- Quick learners/ VERY FAST PACE ENVIRONMENT/multi-tasking
- Computer skills – 2 screens for Excel, Outlook, Word, 4 internal DOS systems.
- Job stability
The referral cycle is this: Doctor prescribes medication to the patient. The patient submits the claim for coverage and the BV rep is investigating to make sure that drug is covered by the policy before it can be administered to the patient. An average BV Rep has 20-30 referrals on their desk at one time and they complete them from start to finish (no other reps would make calls on referrals you are assigned to so it’s 100% your responsibility to see it gets done). To investigate it’s mainly follow up correspondence with the doctors, insurance companies, patients, etc.
- Verify insurance, adjust claims, process prescriptions- Must have at least 1 year of experience verifying insurance.
- Ability to calculate co-payment amounts, deductible amounts, coverage percentages, insurance premiums.
- Candidates should also possess the following skills:
- Prior Pharmacy and/or medical billing experience
- Prior call center experience
- Basic PC and typing skills
- Detail oriented
- Good verbal / written communication skills
- Schedule flexibility
- Able to perform in a fast paced environment
- Good attendance
- Conducting a detailed benefit and eligibility verification of insurance benefits for plan participants, including identifying the different plan and therapy requirements for processing their referrals, and validating the demographic and reimbursement information on all Specialty customers in a database prior to the initiation of therapy.
- Processing POS/Retail billings, relating financial obligations to the participant, and informing internal parties when a new customer is brought on for service.
- This role is predominately phone centric with essential skills in navigating our system to document conversations and outcomes as well as managing follow-up actions with opportunities for internal communications with the sales organization regarding contract and physician issues.
- Responsible for understand and communicate medical information, identify potential issues, collect and document/publish data, establish facts, draw conclusions, and solve problems is essential.
- The commitment is to communicate the referral status every 48 hours to the Physician and Participant with objective of closing 8 referral cases a day, post training.
Apex is an Equal Employment Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by law. Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Employee Services Department at 844-463-6178