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Benefit Verification Specialist
Elevance Health. Review, verify, and document patient insurance coverage for medical and pharmacy benefits .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in patient insurance verification, including knowledge of pharmacy and medical claims, while ensuring compliance with regulatory standards. Proficient in coordinating benefits and communicating effectively with patients and healthcare teams to facilitate timely medication access.
Highest-signal resume keywords
Pharmacy Tech CertificationInsurance Verification ExperienceSpecialty Pharmacy KnowledgeMedicare ExperienceCall Center Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Patient Insurance VerificationClaims ProcessingPrior Authorization SupportBenefit CoordinationCopay Card ManagementClaim ResearchDocumentation SkillsOperational MonitoringFinancial Assistance EnrollmentRegulatory Compliance
Soft Skills
Effective CommunicationProblem-SolvingCollaborationCustomer ServiceAttention to Detail
Certifications & Qualifications
Pharmacy Tech License
Industry Keywords
Pharmacy ServicesInsurance BenefitsAuthorization RequestsPatient ConfidentialityHealthcare Collaboration
About the role
Key responsibilities & impact- Review, verify, and document patient insurance coverage for medical and pharmacy benefits
- Load insurance details, coordinate benefits, and run test claims to confirm coverage and reimbursement outcomes
- Communicate with insurance providers, healthcare teams, and patients to gather and confirm coverage, copays, deductibles, and authorization requirements
- Support prior authorizations, appeals, and enrollment in financial assistance programs
- Ensure accurate patient setup in the system
- Monitor referrals, submit and follow up on authorization requests, and document findings for operational use
- Inform patients about coverage status, financial obligations, and next steps
- Resolve inquiries efficiently, aiming for first-call resolution while maintaining regulatory compliance and patient confidentiality
- Collaborate with pharmacy teams and providers to ensure timely medication access and proper claim processing
Requirements
What you’ll need- HS Diploma or GED
- 1 year of pharmacy or insurance verification experience
- Pharmacy Tech lic or certification highly desired
- Specialty Pharmacy experience preferred
- Pharmacy and Medical claim research experience preferred
- Copay card and/or manufacturing experience preferred
- Call center experience preferred
- General knowledge of company pharmacy services, products, insurance benefits, contracts, and claims preferred
- Experience with Medicare (Parts A–D) and specialty pharmacy preferred
- Must reside within a reasonable commuting distance from one of the posting locations unless an accommodation is granted as required by law
- Ability to work 11am–7:30pm or 11:30am–8pm EST
- Candidates in certain patient/member-facing roles must become vaccinated against COVID-19 and Influenza unless an acceptable explanation is provided
Benefits
Comp & perks- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical benefits
- Dental benefits
- Vision benefits
- Short-term disability benefits
- Long-term disability benefits
- 401(k) + match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
- Hybrid/virtual work flexibility
- Accommodation support for the application process, where applicable
- COVID-19 and Influenza vaccination compliance support as required