Walgreens is outlining the responsibilities of a key role focused on navigating the complexities of patient healthcare coverage. The position requires verifying patient eligibility, coordinating benefits with insurance providers, and determining patient financial responsibility for services.
Navigating Insurance Complexities
The role involves handling a high volume of inbound and outbound communications with customers, physician offices, and insurance companies. Responsibilities include resolving issues related to Pharmacy Benefit Managers (PBMs) and major medical insurance, processing rejections, and assisting with prior authorizations.
The position also requires verifying benefits for major medical coverage, confirming network status, and reviewing guidelines to ensure claims are paid correctly. Individuals in this role may also assist patients with grant applications, copay assistance programs, and specialized programs like patient assistance initiatives.
Required Skills and Experience
Successful candidates will possess a high school diploma or GED and experience providing customer service in a healthcare-related field. Strong communication skills and basic computer proficiency are essential. Preferred qualifications include experience with adherence programs and identifying operational issues.
Walgreens states it will consider applicants with prior arrest and conviction records.
Frequently Asked Questions
What are the primary responsibilities of this position?
The position is responsible for verifying patient eligibility, coordinating benefits, running test claims, and determining patient coverage/responsibility for services, as well as handling inbound and outbound calls related to these processes.
What qualifications are preferred for this role?
Preferred qualifications include experience with providing customer service related to adherence, complex disease states, and identifying operational issues, along with intermediate-level computer skills.
Does Walgreens consider applicants with a criminal record?
Yes, Walgreens states it will consider employment of qualified applicants with arrest and conviction records.
As healthcare systems turn into increasingly complex, how might roles like these evolve to better support patients and providers?
Worth a look