Benefit Verification Specialist - BioPlus Specialty Pharmacy

Elevance Health • Indianapolis, IN

3d • Hybrid

About The Position

The Benefit Verification Specialist at BioPlus Specialty Pharmacy, part of Elevance Health, reviews, verifies, and documents patient insurance coverage for medical and pharmacy benefits. The role includes loading insurance details, coordinating benefits, and running test claims to confirm coverage and reimbursement outcomes.

The specialist communicates with insurance providers, healthcare teams, and patients to confirm coverage details, copays, deductibles, and authorization requirements. The role supports prior authorizations, appeals, and financial assistance enrollment; sets up patients in the system; monitors referrals; submits and follows up on authorization requests; and documents findings. The specialist also explains coverage status, financial obligations, and next steps to patients, resolves inquiries while maintaining regulatory compliance and confidentiality, and collaborates with pharmacy teams and providers to support timely medication access and proper claim processing.

This hybrid role requires working in an office one to two days per week, with candidates expected to live within commuting distance of an office unless an accommodation is granted. The stated hours are 11:00 a.m.–7:30 p.m. or 11:30 a.m.–8:00 p.m. Eastern Time.

Requirements

• High school diploma or GED.
• At least 1 year of pharmacy or insurance verification experience.

Nice To Haves

• Pharmacy technician license or certification.
• Specialty pharmacy experience.
• Pharmacy and medical claim research experience.
• Copay card and/or manufacturing experience.
• Call center experience.
• General knowledge of company pharmacy services, products, insurance benefits, contracts, and claims.
• Experience with Medicare Parts A–D and specialty pharmacy.

Responsibilities

• Communicate with insurance providers, healthcare teams, and patients to gather and confirm coverage, copays, deductibles, and authorization requirements.
• Support prior authorizations, appeals, and enrollment in financial assistance programs.
• Set up patients accurately in the system, monitor referrals, submit and follow up on authorization requests, and document findings.
• Inform patients about their coverage status, financial obligations, and next steps.
• Resolve inquiries efficiently, aiming for first-call resolution, while complying with regulations and patient confidentiality standards.
• Collaborate with pharmacy teams and providers to facilitate timely medication access and proper claim processing.
• Load insurance details, coordinate benefits, and run test claims to confirm coverage and reimbursement outcomes.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs, unless covered by a collective bargaining agreement
• Medical benefits
• Dental benefits
• Vision benefits
• Short- and long-term disability benefits
• 401(k) with matching
• 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