Benefit Verification Technician

American Oncology Network•Urbana, IL

1d•$19 - $32•Remote

About The Position

The Benefit Verification Technician is responsible for verifying insurance coverages, determining medication coverage, and assisting patients with financial responsibilities related to their prescriptions. This role involves direct communication with patients, healthcare providers, and insurance companies to ensure seamless access to necessary medications. The technician will also handle specialty pharmacy referrals and claims resolution, acting as a crucial liaison between various teams to improve patient care and operational efficiency. A strong commitment to compliance with all relevant guidelines and policies is essential.

Requirements

High school education, GED, or equivalent required.
Active/Unrestrictive Pharmacy Technician permit in the state of residence.
Willing to obtain Florida Technician permit (if applicable).
Two years’ experience in specialty, retail, mail order, or hospital pharmacy as a pharmacy technician required.
Critical thinking skills including solid problem solving, analysis, decision-making, planning, time management and organizational skills.
Must be detail oriented with the ability to exercise independent judgment.
Developed interpersonal skills, emotional intelligence, diplomacy, tact, conflict management, delegation skills, and diversity awareness.
Ability to work effectively with sensitive and confidential material and sometimes emotionally charged matters.
Good command of the English language.
Effective communication skills (oral, written, presentation), active listening, and ability to provide balanced feedback.
Strong customer focus.
Ability to build an engaging culture of quality, performance effectiveness and operational excellence.
Effectively manages own time, conflicting priorities, self, stress, and professional development.
Self-motivated and self-starter with ability to work independently with limited supervision.
Ability to work remotely effectively as required.
Must be able to work effectively in a fast-paced, multi-site environment with demonstrated ability to juggle competing priorities and demands.
Proficiency in MS Office Word, Excel, Power Point, and Outlook required.

Nice To Haves

Second language is an asset but not required.

Responsibilities

Verify Private, Medicaid, and Medicare insurance coverages, including VA, IHS, and other unique programs.
Complete patient facility verifications and determine medication coverage.
Verify patient eligibility to utilize AON Pharmacy via test claim to their pharmacy insurance.
Refer prescriptions to Prior Authorization or Financial Assistance teams based on test claim responses.
Offer and enroll patients in manufacturer copay cards for commercial payors.
Determine network coverage for specialty oncology and hematology medications.
Determine which pharmacy can dispense specialty medications on behalf of the patient.
Inform patients of prescription referral to outside pharmacies and notify nursing staff to forward prescriptions.
Document prescription referrals in the EMR system.
Obtain Limited Distribution Overrides for AON Pharmacy to fill.
Understand claim responses and educate patients regarding financial responsibility.
Resolve COB coverage issues with patients and payors to correctly adjudicate claims.
Resolve claim submission issues with outside dispensing pharmacies.
Ensure effective communication and customer service with all internal and external customers.
Actively listen to patient questions and provide accurate answers and solutions.
Address all phone calls professionally, courteously, and in a timely manner.
Act as a liaison between teams to communicate changes and improve interdepartmental processes.
Review incoming team emails to ensure timely and professional responses.
Ensure all department compliance training is completed by established deadlines.
Maintain continuing education requirements for licensure.
Maintain and ensure the confidentiality of all patient and employee information as required by HIPAA regulations.
Assist department management in ensuring the storage, collection, and destruction of Protected Healthcare Information adheres to all federal and state guidelines and accreditation standards.
Perform other duties and projects as assigned.