Insurance Coordinator

We are seeking a highly motivated and detail-oriented Insurance Coordinator to join our team. The Insurance Coordinator is responsible for verifying Found member’s pharmacy insurance coverage and eligibility, obtaining prior authorizations for medications as needed, and ensuring that all necessary insurance documentation is complete and accurate. The ideal candidate will have strong communication and customer service skills, a thorough understanding of medical insurance policies and procedures, and the ability to multitask in a fast-paced environment.

Primary Responsibilities:

1. Verify members pharmacy insurance coverage and eligibility for medication coverage benefits.
2. Obtain prior authorizations for medications.
3. Ensure that all necessary insurance documentation is complete and accurate
4. Communicate with providers, members, and insurance companies to resolve insurance-related or prior authorization issues
5. Maintain accurate and up-to-date member insurance information in electronic health records and/or billing system
6. Provide excellent customer service to members, providers, and insurance companies
7. Stay up-to-date on changes to insurance policies, procedures, and regulations
8. Other related duties as assigned

Required Qualifications:

• Excellent interpersonal and communication skills. Insurance Coordinators must have excellent communication skills, including the ability to explain complex insurance information in plain language, listen actively, and build rapport with members
• Ability to work compassionately and effectively with the public, as well as working with insurance companies, providers, pharmacies, and colleagues at all levels of the organization
• Passionate about delivering safe, high-quality obesity healthcare, and harnessing technology to do so
• Strong aptitude for problem solving. Insurance Coordinators must be able to identify and address issues and develop creative solutions to ensure members receive their full pharmacy benefits
• Ability to execute repetitive tasks with accuracy and attention to detail
• Exceptional organizational abilities, with the ability to organize and prioritize competing priorities
• Adept relationship development skills to work across departments with multiple different stakeholders.
• Must be comfortable using technology, including electronic health records, and insurance benefit verification or insurance billing systems

Minimum required education and experience:

• 1+ years of experience in medical insurance verification
• 1+ years providing remote services (i.e. telehealth practice, customer service, etc.)
• Strong understanding of medical insurance policies and procedures, including prior authorization and claims submission processes
• Understanding of medical terminology
• High school diploma or GED

Ideal education and experience:

• 3+ years of experience in medical insurance verification
• 3+ years providing remote services (i.e. telehealth practice, customer service, etc.)
• Strong understanding of medical insurance policies and procedures, including prior authorization and claims submission processes
• Insurance and reimbursement certification such as Certified Professional Biller (CPB), Certified Billing and Coding Specialist (CBCS), or Certified Medical Reimbursement Specialist (CMRS)
• Completion of a medical terminology course
• Bachelors degree, in Healthcare Administration or similar related field