Eligibility Specialist

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UBC

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2003

🧬 Biotechnology

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Biotechnology • Healthcare Insurance • Pharmaceuticals

UBC is a company dedicated to improving patient outcomes by connecting specialty therapies to patients in need. They provide modern and customized solutions focusing on access, safety, and evidence generation for biopharmaceutical products. UBC specializes in evidence development, risk management, and patient access, utilizing real-world data and innovative technologies to optimize the healthcare journey and ensure effective medication use.

📋 Description

• Provide the highest quality of customer service to patients and client representatives, which entail acquiring in-depth knowledge of client and marketing requirements • Complete verification of Benefits and Eligibility for all referrals from patients, medical doctor’s office (MDOs), health plans and pharmaceutical manufacturers • Investigation of benefits and eligibility by phone and/or internet to determine coverage choices patient has in starting on therapy • Review incoming referrals for completeness of and confirm FDA requirements are met as applicable • Answer all Incoming calls quickly and efficiently, evaluate their need and respond or disseminate call to appropriate member of team • Provide assistance with reimbursement inquiry requests, including insurance benefit verification, prior authorization, denials and appeals, and other reimbursement issues from patients, MDOs, payers and Sales Representatives • May provide billing and coding information related to specific product(s) • Conduct general payer research • Participate in call center activities, triage, and respond to incoming calls from patients, insurance companies, physicians, sales representatives, pharmacies, and homecare agencies • Maintain accurate and complete documentation of all inquiries in order to continuously improve the customer service process and reduce potential legal concerns • Identify and escalate repetitive questions and/or problems so that corrective action can be pursued and expedited • Responsible for good housekeeping techniques, adhering to quality and production standards while complying with all applicable company, state and federal safety and environmental programs and procedures • Other duties as assigned

🎯 Requirements

• High School diploma or equivalent • 3-5 years’ experience in a customer service setting preferably in a call center environment • Previous experience in the PBM and or Healthcare Industry preferred • Computer proficiency in MS Office applications, with database experience preferred • Health insurance claims or patient accounting experience preferred • Knowledge of third-party billing, coding, medical terminology, prior authorizations and appeals preferred • Detail oriented with good analytical skills • Ability to manage multiple priorities and meet deadlines • Excellent written and verbal communication skills, demonstrated ability to communicate with others at all levels • Excellent customer skills-patience to explain details and processes repeatedly, excellent phone presentation skills • Demonstrated ability to handle challenging customers in a professional manner, ability to adapt in a dynamic work environment and make decisions with minimal supervision • Advance problem-solving skills and the ability to work collaboratively with other departments to resolve complex issues with innovative solutions • Ability to work a flexible schedule

🏖️ Benefits

• Remote opportunities • Competitive salaries • Growth opportunities for promotion • 401K with company match* • Tuition reimbursement • Flexible work environment • 20 days PTO, accrued • Paid Holidays • Employee assistance programs • Medical, Dental, and vision coverage • HSA/FSA • Telemedicine(Virtual doctor appointments) • Wellness program • Adoption assistance • Short term disability • Long term disability • Life insurance • Discount programs