Benefits Verification Operations Excellence Manager

2 days ago

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National Association of Specialty Pharmacy (NASP)

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Specialty Pharmacy • Education • Advocacy • Pharmacist • Pharmacists

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Description

• Overseeing the benefit verification process within a specialty and home infusion pharmacy. • Ensuring accurate and timely verification of insurance benefits. • Implementing quality control measures and optimizing efficiency and compliance. • Providing guidance, oversight, training, and performance feedback to ensure high-quality work output. • Developing and maintaining standard operating procedures (SOPs) for benefit verification processes.

Requirements

• Bachelor's degree in Business, Healthcare Administration, or a related field (or equivalent work experience) • Previous experience in benefit verification, insurance eligibility, or pharmacy billing, preferably in a specialty and home infusion pharmacy setting • Strong knowledge of insurance plans, coverage criteria, and reimbursement processes, including Medicare, Medicaid, and commercial payers • Familiarity with pharmacy operations, including medication types, dosage forms, and specialty therapies • Excellent analytical and problem-solving skills, with the ability to interpret complex insurance and reimbursement information • Ability to influence without authority • Strong attention to detail and ability to maintain accuracy while working in a fast-paced environment • Proficient in using pharmacy management systems, billing software, and Microsoft Office Suite • Excellent verbal and written communication skills, with the ability to effectively interact with internal and external stakeholders • Knowledge of HIPAA regulations and commitment to maintain patient privacy and data security

Benefits

• BCBSL Medical • Delta Dental • EyeMed Vision • 401k • Accident & Critical Illness • Life Insurance • PTO, Holiday Pay, and Floating Holidays • Tuition Reimbursement