Customer Support Specialist

We are seeking a Program Support Specialist / Medical Benefit Verification Specialist to join our expanding provider support services team. In this leadership role, you will be responsible for researching and verifying patients’ pharmacy and medical insurance coverage and benefits. Your efforts will ensure accurate and timely processing of insurance claims, supporting both patients and healthcare providers effectively.

Key Responsibilities
- Investigate benefits requests submitted by medical offices via phone or web portal.
- Communicate directly with insurance companies to obtain specialty pharmacy and prescription benefits information.
- Update pharmacy claim processing details such as BIN, PCN, ID, and Group numbers in the patient’s profile within the IPS system.
- Document detailed notes regarding patients’ pharmacy and specialty pharmacy benefits in their profiles.
- Identify, manage, and resolve errors in the IPS error queue.
- Handle and resolve complaints and process insurance claims efficiently.
- Identify priority issues and escalate them as necessary.
- Route relevant information to appropriate departments or concerns.
- Follow up on authorizations and claims to ensure timely resolution.
- Record all call information in accordance with standard operating procedures.
- Generate weekly reports on calls and dispositions.
- Verify accuracy of typed prescriptions and patient/doctor data.
- Recheck prescribed drugs, drug strength, billing, day supply, and refills for accuracy.
- Ensure error-free insurance processing.
- Comply with company-wide information security policies and procedures, adhering to ISO 27001 and 9001 standards.

Required Qualifications
- Strong communication skills with the ability to engage effectively in a fast-paced environment.
- Critical thinking and problem-solving abilities.
- Excellent time management and organizational skills.
- Ability to prioritize tasks and maintain professional composure under pressure.
- Detail-oriented with a specialist focus on benefit verification and claims processing.

Preferred Qualifications and Benefits
Joining Elusa Health means becoming part of a dynamic team committed to your professional growth. You will gain unlimited exposure and experience, working alongside a highly trained and diverse network of professionals. The role offers a supportive learning environment designed to help you polish your skills and build a meaningful career path within one of Lahore’s leading healthcare support service providers.

Employee Benefits Include:
- Health insurance coverage
- Provident fund contributions
- Medical, casual, and annual leave allowances
- On-the-job training opportunities
- Two days off per week
- Annual salary increments
- Loan facility availability
- Employee appreciation programs

At Elusa Health, we are storytellers and market leaders because of the talent we nurture. We provide not only a great learning environment but also the chance to build lasting relationships and memorable experiences. If you thrive in a fast-paced, evolving environment and want to be part of a top healthcare support organization, this opportunity is for you.

After applying, you can expect to hear from our recruitment team within three working days for an initial screening. We look forward to reviewing your application and potentially welcoming you to our team.