Benefit Verification Specialist - BioPlus Specialty Pharmacy

Elevance Health • Chandler, AZ

2d • Remote

About The Position

The Benefit Verification Specialist - BioPlus Specialty Pharmacy 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. This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

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.
• Experience in Medical Billing or Refill Billing desired.
• 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