Benefit Verification Technician

American Oncology Network•Fort Myers, FL

1d•Onsite

About The Position

The Benefit Verification Technician verifies insurance coverage and eligibility for patients using AON Pharmacy, determines medication coverage, and directs prescriptions to the appropriate prior authorization, financial assistance, or specialty pharmacy teams. The role also resolves claims issues, communicates with patients and internal and external stakeholders, documents referrals in the EMR, and provides professional customer service through the pharmacy call center. The technician follows applicable local, state, and federal requirements, corporate policies, pharmacy procedures, accreditation standards, and HIPAA confidentiality requirements. The position may also support compliance activities and perform other duties and projects as assigned. Work is generally Monday to Friday, 8:30 AM–5:00 PM local residence time; occasional overtime and weekend shifts may be required based on location hours and operational needs. The position may require effective remote work and working across multiple sites.

Requirements

High school education, GED, or equivalent.
Active, unrestricted Pharmacy Technician permit in the state of residence.
Willingness to obtain a Florida Technician permit, if applicable.
Two years of experience as a pharmacy technician in specialty, retail, mail order, or hospital pharmacy.
Critical thinking, problem-solving, analytical, decision-making, planning, time-management, and organizational skills; attention to detail and ability to exercise independent judgment.
Interpersonal skills, emotional intelligence, diplomacy, tact, conflict management, delegation skills, and diversity awareness; ability to handle sensitive and confidential material and emotionally charged matters.
Good command of English and effective oral, written, and presentation communication skills; active listening and ability to provide balanced feedback.
Strong customer focus and ability to collaborate and build effective relationships with employees, physicians, and the community.
Ability to manage time, competing priorities, stress, and professional development; self-motivated and able to work independently with limited supervision.
Ability to work remotely effectively as required and in a fast-paced, multi-site environment while managing competing priorities and demands from multiple stakeholders and sites.
Proficiency in Microsoft Word, Excel, PowerPoint, and Outlook.

Nice To Haves

A second language is an asset but is not required.

Responsibilities

Verify private, Medicaid, Medicare, VA, IHS, and other insurance coverage, including coverage for patients in facilities such as hospitals, hospices, rehabilitation centers, assisted living facilities, and skilled nursing facilities.
Use test claims to verify patient eligibility to use AON Pharmacy and determine medication coverage.
Refer prescriptions to prior authorization or financial assistance teams based on test claim responses.
Offer and enroll eligible patients with commercial payors in manufacturer copay card programs.
Determine network coverage for specialty oncology and hematology medications and identify an appropriate dispensing pharmacy.
Notify patients about prescription referrals to outside pharmacies and notify nursing staff to forward prescriptions.
Document prescription referrals in the EMR to inform physicians and clinic staff of the appropriate dispensing pharmacy.
Obtain limited distribution overrides for AON Pharmacy to fill prescriptions.
Interpret claim responses and explain plan structure and financial responsibility to patients.
Resolve coordination of benefits issues with patients and payors and resolve claim submission issues with outside dispensing pharmacies when outside the Intake team's scope.
Provide effective communication and customer service to internal and external customers; listen to patient questions and provide accurate answers and solutions.
Handle calls professionally, courteously, and promptly; act as a liaison between teams to communicate changes and improve interdepartmental processes and patient care.
Review incoming team emails and ensure timely, professional responses.
Follow local, state, and federal guidelines, corporate policies, pharmacy SOPs, and accreditation standards.
Verify that department compliance training is completed by established deadlines and maintain continuing education requirements for licensure.
Protect the confidentiality of patient and employee information in accordance with HIPAA.
Assist department management with compliant storage, collection, and destruction of protected health information.
Perform other duties and projects as assigned.