BioPlus Specialty Pharmacy

Specialty pharmacy delivering personalized medication management

Enrollment Representative - Benefit Investigator

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours

Full-timeAltamonte Springs, FL, USANo salary listedIn-person

About the Job

Requirements

At least 1 year of insurance verification experience.
Proficiency in pharmacy benefit and major medical coverage, including Commercial, Medicare B and supplements, Medicare D, and State Medicaid.
Understanding of health insurance benefit structures, including copay structure, coinsurance, deductibles, out-of-pocket costs, and coordination of benefits.
Ability to read and understand paid and rejected claims.
Ability to read prescriptions and select the appropriate dose and units per day supply.
Computer skills.
Knowledge of medical terminology.
Ability to adhere to C.A.R.T. principles.

Responsibilities

Accurately complete benefit investigations in adherence with the company’s 2-hour brand promise.
Adjudicate claims through Pharmacy Benefit Managers.
Obtain thorough and accurate information by using customer-service phone skills, persistence, and appropriate questions.
Work independently and within a team setting.
Adapt to departmental and company procedures as necessary.
Update sales staff and the verification team with pertinent information.
Perform other duties as assigned by the Manager/Supervisor of Admissions Enrollment.

Desired Qualifications

Certified and Registered Technician preferred.
Communicate effectively.
Work cooperatively and act as a liaison between departments when needed.
Maintain a professional image.

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

Excellent Computer Skills
Knowledge of medical terminology
Excellent communication skills
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

Additional Information

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

BioPlus is an Equal Opportunity Employer

About the Company

BioPlus Specialty Pharmacy

Specialty pharmacy delivering personalized medication management

BioPlus Specialty Pharmacy provides specialized, end-to-end pharmacy services for patients with complex or chronic conditions who need specialty medications. It works with doctors, insurance companies, and drug manufacturers to obtain and deliver the right medications, manage prior authorizations, and support patients through each step of treatment. Its offerings include personalized medication management, patient support, and care coordination to ensure timely access, proper adherence, and safe use of therapies. What sets BioPlus apart is its focus on integrated care: aligning pharmacy operations with providers, insurers, and manufacturers to streamline processes, meet healthcare compliance requirements, and optimize treatment outcomes. The company's goal is to improve patient health outcomes by improving adherence and ensuring patients receive the right medications efficiently and with the support they need.

Company size: 501-1,000
Company stage: Not listed
Total funding: Not listed
Headquarters: Altamonte Springs, FL
Founded: 1989

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