Pharmacy Tech

Public-Facing Underwriter We are seeking a decisive and detail-oriented professional with a strong background in prescription drug insurance and Medicare claims to join our team as a public-facing Underwriter. This is not a "back-office" data entry role; you will be the primary decision-maker responsible for making critical daily determinations on policy underwriting. If you possess a deep understanding of medical insurance contracts and enjoy a fast-paced environment where your expertise directly impacts policyholders, this is your next career move. Duties and Responsibilities: Underwriting & Adjudication: Make high-level decisions necessary to properly adjudicate medical and prescription claims and respond to complex written inquiries. Claims Investigation: Examine, investigate, and research medical insurance claims to ensure accuracy and compliance. Liability Analysis: Analyze claims to determine the extent of insurance carrier liability while interpreting specific contract benefits. Process Management: Efficiently process claims from inception to final determination, ensuring all regulatory standards are met. Client Communication: Serve in a public-facing capacity to articulate determinations and provide clarity on policy underwriting. Experience and Qualifications: Industry Experience: Minimum of 1 year of experience in medical insurance is required. Medicare Expertise: Previous experience with Health, Medicare, or Prescription (Rx) claims adjudication. Medicare Supplement experience is strongly preferred. Technical Proficiency: Strong familiarity with medical terminology, procedure codes, and diagnosis codes. Billing Knowledge: Direct experience with UB/Institutional and HCFA/Professional billing forms. Financial Literacy: Proven ability to accurately interpret and explain Explanations of Benefits (EOBs). Decision-Making: A proven track record of making critical, high-stakes determinations in a professional setting. Compensation / Pay Rate (Up to): $24.50

Created: 2026-03-13