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Enrollment Representative - Benefit Investigator

Job in Hialeah, Miami-Dade County, Florida, 33014, USA
Listing for: BioPlus Specialty Pharmacy
Full Time position
Listed on 2026-08-15
Job specializations:
  • Healthcare
    Healthcare Administration, Healthcare / Medical Sales, Health Insurance
Salary/Wage Range or Industry Benchmark: 35000 - 45000 USD Yearly USD 35000.00 45000.00 YEAR
Job Description & How to Apply Below
  • Full-time
Company Description

As one of the largest and most respected specialty pharmacies, Bio Plus creates a meaningful difference to our patients, prescribers, payers, and pharmaceutical partners.

Our 2
- Hour Patient Acceptance Guarantee gives a quick response to prescribers and patients for critical, time-sensitive treatments. As we continue to grow,we need exceptionally talented, bright, and driven people. If you would like to help us continue tobe theinnovativeleader in our industry, this is your chance to join our team.

Job Description

Representative that gathers pertinent verification of insurance benefits and prepares the appropriate documentation in adherence with company’s 2-hour brand promise. Works efficiently and provides appropriate and timely information to other departments.

Participation in all aspects of patient’s insurance verification functions in adherence to company’s 2-hour brand promise.

Responsibilities
  • Responsible for accurately completing benefit investigations with adherence to company’s 2-hour brand promise
  • Must be proficient in Pharmacy Benefit and Major Medical coverage including Commercial, Medicare B and Supplements, Medicare D and State Medicaid
  • Responsible for a complete understanding of health insurance benefit structure including copay structure, co-insurance, deductibles, out of pocket, coordination of benefits, etc
  • Adjudicate claims through Pharmacy Benefit Managers
  • Ability to read and understand paid and rejected claims
  • Ability to be able to read Rx and select appropriate dose/units per day supply
  • Must have great customer service phone skills with the ability to use persistence and ask the right questions to obtain thorough and accurate information
  • Ability to work independently and within a team setting. Must present positive attitude to create a positive work environment
  • Adapt to departmental and company procedures as necessary
  • Update sales staff and verification team with pertinent information
  • Other Duties as assigned by Manager/Supervisor of Admissions Enrollment
Skills & Abilities
  • Knowledge of medical terminology
  • Ability to work cooperatively and be a liaison between departments when needed
  • Professional image
  • Ability to adhere to C.A.R.T. principles
Qualifications Requirements
  • High School Diploma or Equivalent
  • At least 1 year of insurance verification experience
  • Certified and Registered Technician preferred

Bio Plus offers competitive compensation packages including health care, 401(k),growth potential, and a challenging and exciting work environment.

Bio Plus is an Equal Opportunity Employer

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