Demo

Insurance Verification Coordinator II - Remote

CPRx MSO, LLC
Remote, PA Remote Full Time
POSTED ON 8/5/2025
AVAILABLE BEFORE 10/5/2025
CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services. Job Details: Manage the daily functions of the Insurance Verification area including verification of insurance coverage, re-verifying coverage for existing patients, enter and update patient demographics into the computer system, and securing reimbursement related paperwork. Generate price/coverage quotes. Responsibilities Work effectively and maintain expected productivity. Enter and update patient demographics into the computer system. Verify insurance coverage, calculate costs and document details in the patient profile. Medical vs pharmacy benefit determination. Generate a financial responsibility letter. Review benefits with patient via phone. Identify copay/foundation assistance and/or donated drug. Track, monitor and secure necessary insurance documents. Obtain prior authorizations as required. Coordinate completion of Financial Assistance forms, payment agreements and waivers. Assist with training new employees. Organize and prioritize tasks to be completed. Create new hospital and physician codes as needed. Give high priority to client satisfaction and customer needs. Cooperate with other staff members when planning and organizing reimbursement activities. Demonstrates the ability to work effectively and maintain expected productivity. Meets quality standards, shows pride in performance, and demonstrates reliability and follow-through on all assigned tasks. Assist with researching reimbursement issues. Performs in accordance with system-wide competencies/behaviors. Performs other duties as assigned. Skills & Abilities Excellent written and verbal communication Organization Time Management Professional Requirements HS diploma or GED required. 2 years of insurance verification, prior authorization or other related experience in a physician practice, ancillary provider, or other relevant healthcare setting required. Knowledge of medical terminology required. Knowledge of payer websites, eligibility, coordination of benefits required. Knowledge of pharmacy vs medical payers and authorization required. Knowledge of plan formularies and authorization requirements required. Proficient computer skills and Microsoft Office Products required. Excellent math skills. CarepathRx offers a comprehensive benefit package for full-time employees that includes medical/dental/vision, flexible spending, company-paid life insurance and short-term disability as well as voluntary benefits, 401(k), Paid Time Off and paid holidays. Medical, dental and vision coverage are effective 1st of the month following date of hire. CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country. CarepathRx is transforming pharmacy care delivery for health systems and hospitals, delivering improved patient outcomes that drive clinical, quality and financial results. Through the industry’s most comprehensive, end-to-end hospital pharmacy care delivery model, CarepathRx is turning hospital pharmacy into an active care management strategy and revenue generator while providing support across the patient’s complete healthcare journey. The company takes an enterprise approach, providing a powerful combination of technology, market-leading clinical pharmacy services, and wrap-around services that optimize pharmacy performance across the enterprise for fully integrated pharmacy operations, expanded healthcare services, improved ambulatory access, minimized clinical variation and new health system revenue streams. Today, CarepathRx serves more than 15 health systems and 600 hospitals, with more than 2,400 employees nationwide. For more information about CarepathRx, visit our website. We are always searching for the best talent to join our growing organization. Check out our available opportunities by using the search functionality and filtering options at the top! CarepathRx offers full-time employees a comprehensive benefits package that includes: Paid Company Holidays Paid Time Off and Volunteer Time Off Medical, Dental and Vision Benefits for you and your family 401(k) with Company Match Company-paid Life Insurance and Disability Benefits Supplemental Insurance packages Don't see an open opportunity that matches your skill set just yet? Please click Get Started below or click Introduce Yourself in the top right corner of the page to share your information with us. We will reach out when something becomes available! Additionally, create an account with CarepathRx Careers to set up Job Alerts if something becomes available that peaks your interest! To create an account with CarepathRx Careers, click on Sign In in the top right corner. Once you have created an account and are logged in, click on Job Alerts in top right corner and Create Job Alert! We hope you find a fulfilling career with CarepathRx!

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Insurance Verification Coordinator II - Remote

CarepathRx, Remote in Pennsylvania, PA

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