Specialist, Insurance II
AbbVie
June 25, 2026
Remote friendly (North Chicago, IL)
United States
$27 - $48.80 USD yearly
Market Access
Purpose
The Insurance Specialist II acts as the primary point of contact for Health Care Providers (HCPs) and patients when addressing complicated patient access challenges. Subject matter expert in insurance, prior authorizations, customer service, and alternate funding options. Provides accurate explanations of patients’ medical and/or pharmacy benefits, financial assistance, and access questions; builds/maintains insurance intelligence to support the broader access team.
Responsibilities
- Provide subject matter expertise and best-in-class customer service for inbound/outbound calls; drive first call resolution; handle insurance coverage, verification, prior authorization status, and alternate funding options; provide plan forms/portals/websites; communicate investigation results.
- Investigate and problem solve escalated access issues (complex access, savings/copay card challenges, non-preferred formulary); complete benefit investigations and contact HCP/patient/pharmacy/payor as needed.
- Learn and execute business process/system changes for applicable drugs and channels; maintain understanding of procedures/deviations/case processing to support Insurance Specialist I.
- Document in systems of record; communicate insurance details to HCPs/patients via phone, electronic methods, and fax.
- Identify potential Adverse Event situations for Pharmacovigilance reporting.
- Support changing business priorities; collaborate cross-functionally to improve processes/productivity; liaise with providers, insurers, AbbVie teams, pharmacies, and patients; educate stakeholders on access processes by insurance plan.
- Meet/exceed performance metrics; maintain privacy standards.
- Support Training: assist curriculum/new hires; coach Insurance Specialist Level 1s; complete role-based training, certifications, and competency assessments.
- Understand and comply with all required training and applicable laws/policies; perform other tasks as assigned.
Qualifications
- High school diploma or GED required; degree preferred.
- 2–4 years experience in healthcare/reimbursement; call center/healthcare office/specialty pharmacy preferred.
- Knowledge of commercial/government pharmacy & medical insurance, billing, alternate funding, reimbursement, prior authorization/appeals, specialty pharmacy operations.
- Experience preferred: Medicare Part D, Medicaid, alternate funding, private payers, pharmacy and medical benefits.
- Leadership/teamwork; manage multiple priorities and timelines with accuracy.
- Written/verbal communication skills.
- Customer-service mindset; strong technical skills and attention to detail.
- Organizational and problem-solving skills.
- Microsoft Office and ability to learn/navigate other systems.
Benefits
- Paid time off; medical/dental/vision insurance; 401(k); short-term incentive eligibility.
Application instructions
- Not provided in the job description excerpt.
The Insurance Specialist II acts as the primary point of contact for Health Care Providers (HCPs) and patients when addressing complicated patient access challenges. Subject matter expert in insurance, prior authorizations, customer service, and alternate funding options. Provides accurate explanations of patients’ medical and/or pharmacy benefits, financial assistance, and access questions; builds/maintains insurance intelligence to support the broader access team.
Responsibilities
- Provide subject matter expertise and best-in-class customer service for inbound/outbound calls; drive first call resolution; handle insurance coverage, verification, prior authorization status, and alternate funding options; provide plan forms/portals/websites; communicate investigation results.
- Investigate and problem solve escalated access issues (complex access, savings/copay card challenges, non-preferred formulary); complete benefit investigations and contact HCP/patient/pharmacy/payor as needed.
- Learn and execute business process/system changes for applicable drugs and channels; maintain understanding of procedures/deviations/case processing to support Insurance Specialist I.
- Document in systems of record; communicate insurance details to HCPs/patients via phone, electronic methods, and fax.
- Identify potential Adverse Event situations for Pharmacovigilance reporting.
- Support changing business priorities; collaborate cross-functionally to improve processes/productivity; liaise with providers, insurers, AbbVie teams, pharmacies, and patients; educate stakeholders on access processes by insurance plan.
- Meet/exceed performance metrics; maintain privacy standards.
- Support Training: assist curriculum/new hires; coach Insurance Specialist Level 1s; complete role-based training, certifications, and competency assessments.
- Understand and comply with all required training and applicable laws/policies; perform other tasks as assigned.
Qualifications
- High school diploma or GED required; degree preferred.
- 2–4 years experience in healthcare/reimbursement; call center/healthcare office/specialty pharmacy preferred.
- Knowledge of commercial/government pharmacy & medical insurance, billing, alternate funding, reimbursement, prior authorization/appeals, specialty pharmacy operations.
- Experience preferred: Medicare Part D, Medicaid, alternate funding, private payers, pharmacy and medical benefits.
- Leadership/teamwork; manage multiple priorities and timelines with accuracy.
- Written/verbal communication skills.
- Customer-service mindset; strong technical skills and attention to detail.
- Organizational and problem-solving skills.
- Microsoft Office and ability to learn/navigate other systems.
Benefits
- Paid time off; medical/dental/vision insurance; 401(k); short-term incentive eligibility.
Application instructions
- Not provided in the job description excerpt.