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Kforce has a client in search of an Insurance Specialist in Franklin, Tennessee (TN).Essential Responsibilities:
Verifies insurance coverage by phone, online or through E1 (electronic system) transactions for all new patients and/or changes in coverage
Initiates prior authorizations
Reaches out to clinic staff regarding prior authorization information
Contacts all new patients (via telephone) to verify the amount(s) that will be paid out-of-pocket/co-pays
Maintains confidentiality of information at all times
Assists patients with understanding their pharmacy benefits and available resources
Educates patients regarding availability of alternative insurance options, such as providing Medicare part D assistance and education
Assists when insurance coverage changes between companies or to Medicare, and/or refers patients to a social worker
Answers patient's questions regarding insurance coverage
Refers escalated questions/situations to supervisor or appropriate department (such as Billing to address a Billing error), or if a patient wants to opt out of the program
Enters patient's insurance information under the patient's account in the pharmacy data system
Reviews all enrollment forms
Ensures insurance information and appropriate referrals have been completely and accurately obtained
May be required to follow up with social worker, insurance company, and/or patient to complete the application and verify insurance
Monitors all patient's insurance information to ensure that it is updated and accurate
Addresses any identified anomalies or discrepancies, researches and answers questions as needed
Analyzes patient reports from pharmacy data system as an audit check to ensure the correct insurance information is entered and that other changes are not overlooked
High School diploma or equivalent required
Pharmacy Technician Certification preferred
1-2 years of pharmacy claims experience
Prior courses in insurance billing and data processing preferred
Excellent customer service, communication, organizational and interpersonal skills required
Understands the importance of, and demonstrates a customer service philosophy
Excellent written and verbal communication skills
Excellent organizational and analytical skills
Demonstrates knowledge and understanding of insurance billing requirements
Detail oriented with the ability to enter information accurately on paper and into a database system
Proficient with PCs and Microsoft Office applications
Develops a working knowledge of pharmacy dispensing regulations, pharmacy data systems, and pharmacy billing practices and policies
Develops a working knowledge of standard medical abbreviations and medical terminology
Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.Compensation Type:Hours
Vacancy expired!