
Medication Verification Specialist
6 hours ago
The Virtual Pharmacy Specialist will play a crucial role in ensuring the accuracy and compliance of medication verification, claims review, and patient data integration.
This role requires a high degree of technical expertise and attention to detail. The specialist will utilize AI-driven tools to verify medication accuracy and format, cross-check medications against prescriptions to ensure correct dosage and format, flag missing or duplicate tablets and debris for removal, highlight patients with missing data for re-entry (black screens), and provide feedback on AI performance to improve accuracy and reliability.
Claims Review & Submission:- Review insurance/government claims before submission to ensure accuracy and compliance.
- Verify patient eligibility for financial assistance programs and document submissions.
- Check paperwork for completeness and resolve discrepancies in documentation.
- Collaborate with the billing team to streamline claims submission processes.
- Facilitate data migration from external systems into dispensing systems during new patient onboarding.
- Validate and reconcile data to ensure accuracy and completeness.
- Collaborate with onboarding teams to ensure seamless integration.
- Process monthly orders from customers by reviewing orders and entering them into the dispensing system.
- Respond to first-line customer queries regarding order status and delivery expectations.
- Active pharmacist license (state or national, as applicable).
- 2+ years of experience in pharmacy operations, claims management, or clinical pharmacy.
- Familiarity with insurance claims, financial aid programs, and medication therapy management.
- Strong understanding of pharmacology, medication identification, and healthcare compliance.
- Proficiency with technology, including AI tools and claims management systems.
- Exceptional attention to detail and analytical skills.
- Experience with medication packaging systems such as sachets or blister packs.
- Knowledge of AI applications in healthcare or pharmacy operations.
- Background in patient financial assistance programs or insurance processes.
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