Specialist, Insurance II
AbbVie
August 24, 2026
Remote friendly (North Chicago, IL)
United States
$27 - $48.80 USD yearly
Patient Advocacy
Responsibilities:
- Act as primary point of contact for HCPs and patients on complex patient access challenges; provide insurance coverage/verification, prior authorization status, and alternate funding options.
- Provide best-in-class customer service to drive first-call resolution; communicate investigation results and educate customers.
- Investigate and resolve escalated patient issues (complex/disadvantaged access, savings/copay card challenges, non-preferred formulary); perform benefit investigations and contact relevant parties (HCP/patient/pharmacy/payor) as needed.
- Learn and execute business process and system changes for drugs/channel sources; maintain understanding of procedures and case processing.
- Document in the system of record and accurately communicate insurance details via phone/electronic communication/fax.
- Identify potential adverse event situations for Pharmacovigilance.
- Support changing priorities; work cross-functionally to improve processes/productivity; liaise with providers, insurance companies, patient access field teams, filling pharmacies, and patients; educate on access processes.
- Meet/exceed performance metrics; uphold required privacy standards.
- Support training (curriculum/new hires); coach Insurance Specialist Level Is; complete role-based training, including certifications/assessments.
- Comply with required training and policies; perform additional tasks/projects as needed.
Qualifications:
- High school diploma or GED required; degree preferred.
- 2–4 years in healthcare or reimbursement; call center/healthcare office/specialty pharmacy preferred.
- Knowledge of commercial/government pharmacy and medical insurance, billing, alternate funding, reimbursement, prior authorization/appeals, and specialty pharmacy operations.
- Preferred: Medicare Part D, Medicaid, alternate funding, private payers, pharmacy and medical benefits.
- Team leadership, ability to manage multiple priorities/timelines with accuracy.
- Strong written/verbal communication.
- Positive service mindset with challenging issues.
- Strong technical/detail-oriented skills; organizational and problem-solving skills.
- Proficient with Microsoft Office; ability to learn/navigate other systems.
Benefits:
- Paid time off (vacation, holidays, sick), medical/dental/vision insurance, and 401(k) for eligible employees.
- Eligible for short-term incentive programs.
Application instructions:
- None provided.
- Act as primary point of contact for HCPs and patients on complex patient access challenges; provide insurance coverage/verification, prior authorization status, and alternate funding options.
- Provide best-in-class customer service to drive first-call resolution; communicate investigation results and educate customers.
- Investigate and resolve escalated patient issues (complex/disadvantaged access, savings/copay card challenges, non-preferred formulary); perform benefit investigations and contact relevant parties (HCP/patient/pharmacy/payor) as needed.
- Learn and execute business process and system changes for drugs/channel sources; maintain understanding of procedures and case processing.
- Document in the system of record and accurately communicate insurance details via phone/electronic communication/fax.
- Identify potential adverse event situations for Pharmacovigilance.
- Support changing priorities; work cross-functionally to improve processes/productivity; liaise with providers, insurance companies, patient access field teams, filling pharmacies, and patients; educate on access processes.
- Meet/exceed performance metrics; uphold required privacy standards.
- Support training (curriculum/new hires); coach Insurance Specialist Level Is; complete role-based training, including certifications/assessments.
- Comply with required training and policies; perform additional tasks/projects as needed.
Qualifications:
- High school diploma or GED required; degree preferred.
- 2–4 years in healthcare or reimbursement; call center/healthcare office/specialty pharmacy preferred.
- Knowledge of commercial/government pharmacy and medical insurance, billing, alternate funding, reimbursement, prior authorization/appeals, and specialty pharmacy operations.
- Preferred: Medicare Part D, Medicaid, alternate funding, private payers, pharmacy and medical benefits.
- Team leadership, ability to manage multiple priorities/timelines with accuracy.
- Strong written/verbal communication.
- Positive service mindset with challenging issues.
- Strong technical/detail-oriented skills; organizational and problem-solving skills.
- Proficient with Microsoft Office; ability to learn/navigate other systems.
Benefits:
- Paid time off (vacation, holidays, sick), medical/dental/vision insurance, and 401(k) for eligible employees.
- Eligible for short-term incentive programs.
Application instructions:
- None provided.