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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.