Search the 5 jobs at BioPlus Specialty Pharmacy

The Coverage Determination Representative gathers information for authorizations, submits authorization forms to insurance companies, and tracks the progress. Responsibilities include reviewing prescriptions, notifying staff of approval/denials, and documenting statuses. Excellent communication and MS Office skills are essential for this role.

The Coverage Determination Representative is responsible for obtaining and processing prior authorizations for medications, ensuring accuracy of submissions, and communicating outcomes with prescribers and sales staff. This role requires documentation and coordination with insurance companies and prescriber offices.

The Appeals Coordinator manages gathering information for appeals, writing and submitting appeal letters to insurance companies, and handling follow-ups and documentation. Responsibilities include confirming requests, verifying information, and maintaining spreadsheets to track appeal statuses.

As an Account Manager for Payor Relations, you will manage payor relations, support contract implementation, analyze contracts, and ensure compliance with contract obligations. You will also serve as the primary contact for accounts, coordinate with internal stakeholders, and provide insights to facilitate problem resolution and client satisfaction.

The Enrollment Representative - Benefit Investigator is responsible for conducting insurance benefit verifications, preparing documentation quickly, and ensuring compliance with the company’s two-hour response promise. Key responsibilities include understanding various health insurance structures, adjudicating claims, maintaining communication with sales and verification teams, and delivering excellent customer service.