Insurance Verification Specialist - Remote Opportunity in Michigan - Join Walgreens Team

Unlock Your Career Potential as an Insurance Verification Specialist with Walgreens

At Walgreens, we're committed to creating more joyful lives through better health. As a leading healthcare, pharmacy, and retail organization, we're dedicated to making a positive impact on the communities we serve. With a rich history spanning over 170 years, we've established ourselves as a trusted neighborhood health destination, serving nearly 10 million customers daily. We're now seeking an experienced and skilled Insurance Verification Specialist to join our team on a remote basis in Michigan.

About the Role

As an Insurance Verification Specialist, you will play a critical role in ensuring seamless interactions between our customers, physician offices, patients, and third-party providers. This hybrid role offers the flexibility to balance your time between our remote office and home, allowing you to work in an environment that suits your needs. You will be responsible for verifying patient eligibility, coordinating benefits, running test claims, and determining patient coverage/responsibility for services. Your excellent communication skills and ability to work under direct supervision will enable you to provide efficient and courteous service to all contacts.

Key Responsibilities

• Respond to inbound and outbound calls related to Pharmacy Benefit Manager (PBM) and major medical insurance, resolving questions and problems submitted by customers and PBMs following established guidelines and standard SOPs.
• Request and load PBM and/or Major Medical insurance plans, processing non-clinical PBM rejections, and assisting physicians in the prior authorization process.
• Verify benefits for Major Medical via online resources or over the phone, confirming network status, reviewing FDA guidelines, and prior authorization requirements to ensure payment of claims.
• Facilitate reimbursement windshields for PBM major medical claims, identify and assess individual customer or patient needs, and provide education on or assist with grant applications, complex funding needs, and commercial copay assistance enrollment.
• Provide primary support and expertise for specialized programs, manage Pharma requirements, and administer order queues as needed.
• Document contact interactions, recording details, complaints, comments, and actions taken.

Essential Qualifications

To be successful in this role, you will need:

• A high school diploma or GED.
• Experience providing customer service to internal and external customers in a healthcare, specialty pharmacy, PBM, or call center setting.
• The ability to communicate clearly and effectively, both written and verbal, with good interpersonal skills and the ability to communicate in a diplomatic and confidential manner.
• Basic level PC skills, including MS Windows, MS Office Suite, and/or other similar operating/software programs.

Preferred Qualifications

While not mandatory, the following qualifications will give you a competitive edge:

• Experience with providing customer service related to adherence, complex disease states, quality, After Call Work (ACW), etc.
• Experience in identifying operational issues and recommending and implementing strategies to resolve problems.
• Intermediate level PC skills, including MS Windows, MS Office Suite, and/or other similar operating/software programs.

What We Offer

As a Walgreens team member, you can expect:

• A competitive hourly rate between $15.00 to $20.00, depending on experience, seniority, geographic location, and other factors permitted by law.
• A comprehensive benefits package, including details available at jobs.walgreens.com/benefits.
• Opportunities for career growth and professional development within our organization.
• A dynamic and supportive work environment that values diversity, equity, and inclusion.

Company Culture and Work Environment

At Walgreens, we're committed to fostering a culture that is inclusive, collaborative, and empowering. As a remote team member, you'll have the flexibility to work from home while still being connected to our broader team. We're proud to be an Equal Opportunity Employer, including disability/veterans, and we're dedicated to creating a workplace that is welcoming and supportive for all employees.

Career Growth Opportunities

As an Insurance Verification Specialist, you'll have opportunities to develop your skills and expertise in a dynamic and growing field. You'll be able to take on new challenges, expand your knowledge, and advance your career within our organization. We're committed to helping our team members achieve their career goals and providing the support and resources needed to succeed.

Learning Benefits

At Walgreens, we're dedicated to providing our team members with the training and development opportunities needed to excel in their roles. As an Insurance Verification Specialist, you'll have access to comprehensive training programs, ongoing support, and resources to help you stay up-to-date on industry trends and best practices.

Join Our Team

If you're a motivated and experienced professional looking for a new challenge, we encourage you to apply for this exciting opportunity. As an Insurance Verification Specialist with Walgreens, you'll be part of a dynamic team that's dedicated to making a positive impact on the communities we serve. Don't hesitate – apply today and let's build the future together!

To learn more about our company and this role, or to submit your application, please visit our website. We look forward to hearing from you!