Medical Insurance Specialist - Call Center

Job Description

Position Summary:

AllCare Plus Pharmacy works with all major insurance companies. We are also well networked with manufacturers and assistance programs for patients who need additional coverage. Our Care Managers (Medical Insurance Specialists) are responsible for contacting insurance companies to obtain correct eligibility information, perform benefit investigations, copay assistance and check prior authorization and/ or appeal status.


The information contained herein is intended to be an accurate reflection of the duties and responsibilities of the individuals assigned to this position. They are not intended to be an exhaustive list of the skills and abilities required to do the job. AllCare Plus Pharmacy reserves the right to revise the job or to require that other or different tasks be performed as assigned.


Medical Insurance Specialist/Customer Care Manager

Primary Responsibilities:

  1. Responsible for answering in-bound calls and assisting customers with pharmacy related services

  2. Obtain client information by answering telephone calls; interviewing clients; verifying information

  3. Contact insurance companies for benefit investigation and coverage eligibility

  4. Complete prior authorizations with attention to detail and accuracy, to then have the prepared prior authorization reviewed by a clinical pharmacist

  5. Assist patients with the enrollment process for manufacturer and non-profit organization copay assistance programs

  6. Provide customers with courteous, friendly, fast and efficient service

  7. Update job knowledge by participating in educational opportunities and training activities.

  8. Work efficiently both individually and within a team to accomplish required tasks

  9. Maintain and improve quality results by adhering to standards and guidelines and recommending improved procedures


Required Qualifications:

  1. High School Diploma or equivalent, some college preferred

  2. Minimum one year experience in medical billing, insurance verification, or similar related medical office experience

  3. Previous data entry experience (minimum three months) and ability to type 30wpm+


Preferred Qualifications:

  1. Customer Service experience

  2. Flexible work schedule

  3. Bilingual (Spanish) highly desirable

Ability to use MS Office

Company Description
AllCare Plus Pharmacy is a premier specialty pharmacy located in Northborough, MA. We provide a full range of pharmacy services while specializing in complex medication management. AllCare Plus Pharmacy combines caring, personalized service with exceptional clinical knowledge and innovative compliance programs. We make the treatment of difficult diseases as simple, safe, and effective as possible.

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