Search the 5 jobs at BioPlus Specialty Pharmacy

The Enrollment Representative is responsible for verifying insurance benefits and preparing documentation in line with the company's brand promise. The role requires proficiency in Pharmacy Benefit and Major Medical Insurance, understanding of health insurance structures, and excellent customer service skills. Responsibilities include adjudicating claims, updating teams, and ensuring compliance with company procedures.

The Coverage Determination Representative is responsible for gathering and submitting authorization forms to insurance companies and maintaining documentation of authorizations. They must have knowledge of medical terminology and pharmacy prior authorization processes, as well as proficiency in MS Office software.

The Coverage Determination Representative gathers necessary information for authorization requests, processes and submits these requests to insurance companies, tracks authorization outcomes, and communicates with prescriber offices and internal staff. They are also responsible for documenting all authorization statuses and updating relevant parties with crucial information.

The Appeals Coordinator is responsible for managing appeals by gathering necessary information, writing and submitting appeal letters to insurance companies, following up on statuses, and maintaining documentation of appeals. This role serves as a liaison between prescribers, patients, and insurance providers.

The Account Manager - Payor Relations is responsible for managing payor relations and contractual obligations, providing analysis of contracts, facilitating internal communication, and ensuring compliance. The role includes serving as the primary contact for accounts, maintaining proposal libraries, supporting business development, and analyzing reports related to payor contracts.