Benefit Verification Specialist - BioPlus Specialty Pharmacy

Elevance Health • Atlanta, FL

2d • Hybrid

About The Position

BioPlus Specialty Pharmacy, a proud member of the Elevance Health family of companies, is seeking a Benefit Verification Specialist. This role is crucial for providing consumers and providers with an unparalleled level of service focused on whole health. The specialist will leverage clinical expertise, digital capabilities, and broad access to specialty medications to deliver an elevated experience, affordability, and personalized support throughout the consumer's treatment journey. The Benefit Verification Specialist will be responsible for accurately reviewing, verifying, and documenting patient insurance coverage for both medical and pharmacy benefits. This includes loading insurance details, coordinating benefits, and running test claims to confirm coverage and reimbursement outcomes.

Requirements

• Requires HS Diploma or GED
• 1 year of pharmacy or insurance verification experience.

Nice To Haves

• Pharmacy Tech lic or certification highly desired.
• Specialty Pharmacy experience preferred.
• Pharmacy and Medical claim research experience preferred.
• Copay card and/or manufacturing experience preferred.
• Call center experience preferred.
• General knowledge of company pharmacy services, products, insurance benefits, contracts, and claims preferred.
• Experience with Medicare (Parts A–D) and specialty pharmacy is preferred.

Responsibilities

• Communicating with insurance providers, healthcare teams, and patients to gather and confirm benefit information such as coverage, copays, deductibles, and authorization requirements.
• Support prior authorizations, appeals, and enrollment in financial assistance programs.
• Ensure accurate patient setup in the system, monitoring referrals, submitting, and following up on authorization requests, and documenting all findings for operational use.
• Inform the patient regarding their coverage status, financial obligations, and next steps.
• Resolve inquiries efficiently, aiming for first-call resolution, while maintaining compliance with regulations and patient confidentiality standards.
• Collaboration with pharmacy teams and providers to ensure timely medication access and proper claim processing.

Benefits

• merit increases
• paid holidays
• Paid Time Off
• incentive bonus programs
• medical
• dental
• vision
• short and long term disability benefits
• 401(k) +match
• stock purchase plan
• life insurance
• wellness programs
• financial education resources

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED