Specialist, Insurance II- Permanent role

AbbVie's mission is to discover and deliver innovative medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's lives across several key therapeutic areas – immunology, oncology, neuroscience, and eye care – and products and services in our Allergan Aesthetics portfolio. For more information about AbbVie, please visit us at www.abbvie.com. Follow @abbvie on X, Facebook, Instagram, YouTube, LinkedIn and Tik Tok.

The Insurance Specialist II acts as the primary point of contact for Health Care Providers (HCPs) and patients when addressing complicated patient access challenges. This position will be a subject matter expert in insurance, prior authorizations, best-in-class customer service, and alternate funding options . The position addresses issues and concerns to provide HCPs and patients with accurate explanations of patients’ medicaland/or pharmacy benefits, financial assistance, and access questions. Additionally, this position enables the productivity of the broader access team by building, maintaining and providing access to the insurance intelligence.

• Provide subject matter expertise and best-in-class customer service for all inbound and outbound customercalls to drive first call resolution.
• Provide insurance coverage, verification details prior authorization statuesand alternate funding options for existing and newly launched products.
• Provide offices with current plan forms, portals, and websites for prior authorizations and appeal submissions.
• Clearly communicate and educate customers on results of the investigation Investigate and problem solve for patients experiencing escalated issues such as disadvantaged or complex access, savings card/copay card challenges or non-preferred formulary issues.
• Where necessary, complete abenefit investigation, contact the HCP and/or patient or potentially the filling pharmacy or payor.
• Quickly learn and execute business process and system changes for all drugs and channel sources as applicable.
• Maintain an understanding of current business procedures, deviations, and case processing for allbrands and channel sources for Insurance Specialist I role to support as needed.
• Documents information in the appropriate system of recordand formats. Accurately communicate insurancedetails to HCP and patients via phone, other electronic communication methods and fax, as per establishedpolicies and procedures.
• Identify potential Adverse Event situations for reporting to Pharmacovigilance ensuring AbbVie meets FDAregulations. Support changing business priorities by being flexible in executing or overseeing completion of specific tasks to support the patients, products, or services we provide for all current and new products.
• Work cross-functionally to identify and share opportunities for process and productivity improvements. Liaise between healthcare providers, insurance companies, AbbVie Patient Access Support field rep.s, Ambassadors, filling pharmacies and patients to administer the Patient Support Service programs. Educatehealthcare providers, AbbVie Patient Access Support field representatives, filling pharmacies, and patientson access processes specific to their patient's insurance plan.
• Meet or exceed department standards relative to performance metrics.
• Maintain a work environment that upholds privacy standards required by law and AbbVie policy.
• Act as a resource for the Training department including providing support for training curriculum and newhires.
• Provide side by side coaching and assistance for Insurance Specialist Level 1s. Successfully complete role based training requirements, including passing certifications and competency assessments prior to conclusion of training period.
• Understand and comply with all required training, including adherence to federal, state, and local laws, SPII policies and guidelines, and the policies and procedures of AbbVie Access Support and AbbVie. Perform additional tasks, activities, and projects as deemed necessary by management.

• High school diploma or GED equivalent required.
• Experience and knowledge in Medicare Part D, Medicaid and alternate funding resources, private payers,pharmacy benefits, and medical benefits preferred.
• Demonstrated ability to lead and participate within a team, manage multiple priorities and meet associated timelines while maintaining accuracy.
• Proven leadership skills.
• Professional written and verbal communication skills are required. Ability to maintain a positive service image at all times even when dealing with challenging issues and unsatisfied customers.
• Demonstrated strong, accurate technical skills.
• Must be detail oriented.
• Proven organizational and problem-solving skills, elevating to management when appropriate.
• Skilled with the use of the Microsoft Office suite, and the ability to use and effectively learn and navigate other computer systems.
  
  Preferred
   
• 2-4 years of work experience in a healthcare or reimbursement setting; previous experience in a call center environment, healthcare office, or specialty pharmacy preferred.
• Understanding and knowledge of commercial and government pharmacy and medical insurance programs,billing, alternate funding resources, reimbursement processes, prior authorization and appeal filings, and specialty pharmacy operations

En AbbVie estamos comprometidos a cultivar una cultura laboral que promueva la inclusión, la diversidad y el crecimiento personal. Reconocemos que nuestro éxito colectivo se basa en el bienestar individual de nuestros colaboradores y es por eso que hemos diseñado un paquete de beneficios pensando en cada aspecto de su vida.

• Cobertura Mejorada de Salud y Bienestar: Nuestro personal administrativo goza de un seguro médico y dental integral, asegurando tranquilidad para usted y sus seres queridos.
• Vacaciones Extendidas: Creemos en el equilibrio entre el trabajo y la vida personal de nuestro equipo administrativo. Por eso ofrecemos días adicionales de vacaciones, más allá de los requisitos legales.
• Modelo de Trabajo Híbrido Flexible: Para los puestos elegibles dentro de nuestro personal administrativo, adoptamos un esquema de trabajo híbrido que le permite la comodidad de teletrabajar durante dos días a la semana.
• Seguro de Vida: Asegure el futuro de su familia con nuestra póliza de seguro de vida.
• Avance Educativo: Invierta en su futuro con nuestro programa de becas disponible para empleados y sus dependientes.
• Programa de Asistencia al Empleado (EAP): Acceda a apoyo profesional con nuestro EAP integral, que ofrece asesoramiento psicológico, legal y financiero.
• Servicios de Salud en la Empresa: Benefíciese de la comodidad de contar con un médico de la empresa y servicios de fisioterapia, demostrando nuestro compromiso con su salud y bienestar.
• Compromiso Comunitario y Social: Haga la diferencia con un día de voluntariado pagado, que le permite contribuir a la comunidad durante el horario laboral de la empresa.
• Beneficios Especiales de Permiso: Celebre sus logros de vida con días adicionales de permiso por matrimonio y disfrute de su cumpleaños con un día libre.
• Plan de Compra de Acciones para Empleados: Participe en el éxito de nuestra compañía comprando acciones a un precio especial exclusivo para empleados.
• Transporte y Comidas Subsidiadas: Disfrute de la facilidad de transporte y de las comidas con nuestros servicios de transporte y cafetería subsidiados.
• Asociación Solidarista: Únase a una comunidad enfocada en la ayuda mutua y disfrute de los beneficios que conlleva ser miembro.

AbbVie is an equal opportunity employer and is committed to operating with integrity, driving innovation, transforming lives and serving our community.  Equal Opportunity Employer/Veterans/Disabled. 

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