Benefits Verif Tech

Benefits

Verification Technician Why Birdi? At Birdi, we're focused on making the pharmacy experience easier and more supportive for the patients we serve. Our teams work behind the scenes to remove barriers, resolve insurance issues, and help patients receive their medications accurately and on time. As a Benefits Verification Technician , you'll play an important role in that experience by navigating insurance requirements, resolving prescription claim issues, and helping patients, providers, and payers find solutions.

About the Role

The Benefits Verification Technician supports patients, insurance carriers, providers, and internal pharmacy teams with prescription eligibility, benefits verification, billing, and claims processing. In this role, you'll research and resolve insurance-related prescription issues, process prescriptions using current coverage information, coordinate with Pharmacy Benefit Managers (PBMs), and communicate with patients, providers, pharmacies, and payers.

You'll also serve as a resource to the broader team by helping track payer changes, supporting training, and staying current with evolving claims adjudication requirements.

What You'll Do

Benefits

Verification & Claims Support Verify prescription eligibility and insurance information to support accurate claims processing. Process prescriptions using current insurance information and payer requirements. Research rejected claims and work toward timely resolution. Coordinate adjudication support with Pharmacy Benefit Management (PBM) services.

Assist with prescription and business audits conducted by third-party payers. Stay current on changing payer requirements, adjudication standards, and billing processes. Patient, Provider & Payer Communication Make outbound calls to patients, providers, and insurance carriers to obtain prescription or billing clarification.

Follow up as necessary to help resolve outstanding prescription issues. Contact patients to obtain required information or communicate potential delays in order processing. Respond professionally to routine inquiries from patients, providers, pharmacies, and payers. Coordinate with pharmacists when clinical or prescription issues require additional support.

Problem Solving & Issue Resolution Investigate prescription processing and insurance-related issues to determine the cause. Use available resources to identify appropriate solutions. Escalate complex or unresolved concerns to supervisors when necessary. Help ensure prescription issues are followed through to resolution.

Apply strong critical-thinking skills while balancing payer requirements, pharmacy processes, and patient needs. Documentation & Quality Maintain accurate records of correspondence with patients, providers, pharmacies, and insurance carriers. Document inquiries, complaints, comments, and actions taken. Meet established productivity and quality performance goals.

Maintain accurate payer reference materials as requirements change. Protect confidential patient and company information at all times. Team Support & Continuous Improvement Assist with training and departmental updates for pharmacy technicians. Support Customer Service and other departments with prescription-related questions and patient correspondence.

Partner with leadership on updates to departmental processes and procedures. Help communicate changes in payer requirements and adjudication standards to the team. Identify opportunities to improve processes and the overall patient experience.

What You'll Bring

Required Qualifications Education & Licensure High School Diploma or equivalent required. Current Nationally Certified Pharmacy Technician or Registered Pharmacy Technician in good standing with the applicable State Board of Pharmacy. Experience 2+ years of experience in a pharmacy setting. Pharmacy technician experience with exposure to prescription processing and patient support.

Knowledge, Skills & Abilities Excellent verbal and written communication skills. Strong interpersonal and customer service skills. Excellent attention to detail and organizational abilities. Strong time-management skills with the ability to prioritize work and meet deadlines. Strong analytical and critical-thinking skills.

Ability to independently research and resolve issues. Ability to exercise sound judgment, protect confidential information, and communicate diplomatically. Ability to collaborate effectively with pharmacists, technicians, and other team members. Ability to work independently while contributing to a team environment. Ability to perform effectively in a fast-paced environment.

Proficiency with Microsoft Office and pharmacy-related software. Flexibility to work extended hours, weekends, and holidays based on business needs.

Preferred Qualifications

Undergraduate degree or equivalent relevant work experience. Knowledge of pharmacy claims adjudication. Knowledge of secondary billing practices, including: Prescription discount cards Medicaid Previous experience within: Retail Pharmacy Mail Order Pharmacy Specialty Pharmacy Pharmacy Benefit Management (PBM) Pharmaceutical Industry Managed Care Experience working directly with insurance carriers and resolving rejected prescription claims.

Key Competencies Benefits Verification Claims Adjudication Insurance & Payer Navigation Problem Solving Patient Service Attention to Detail Critical Thinking Documentation Accuracy Communication & Follow-Through Team Collaboration Quality & Productivity Confidentiality Work Environment Typical office environment with minimal exposure to excessive noise or adverse environmental conditions.

Prolonged periods of sitting, standing, walking, and working at a computer. Ability to bend, reach, stoop, and kneel as necessary. Ability to use visual acuity to operate equipment and review detailed information. Ability to lift up to 15 pounds as needed. Why This Role Matters Insurance and billing issues can quickly become barriers between patients and the medications they need.

As a Benefits Verification Technician , you'll help remove those barriers. Whether you're researching a rejected claim, clarifying insurance information, working with a provider, or keeping a patient informed about their prescription, your work helps move issues toward resolution and creates a smoother pharmacy experience.

It's a role for someone who enjoys solving problems, digging into the details, and helping patients get to "yes." Equal Employment Opportunity Statement Birdi is an Equal Opportunity Employer and is committed to fostering an inclusive and diverse workplace. We make employment decisions without regard to race, color, religion, creed, sex, gender, sexual orientation, gender identity or expression, national origin, age, disability, protected veteran status, marital status, genetic information, or any other characteristic protected by applicable federal, state, or local laws.

Birdi is committed to providing reasonable accommodations to qualified individuals with disabilities throughout the recruitment process and employment relationship. If you require an accommodation, please notify a member of our Talent Acquisition team.