Insurance Resolution Specialist

Pittsburgh, PA posted on October 9

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PANTHERx® Specialty Pharmacy is THE Rare Disease Specialty Pharmacy®, servicing patients nationwide, and headquartered in Pittsburgh, Pennsylvania. PANTHERx Specialty's mission is to transform lives by delivering medical breakthroughs, clinical excellence, and access solutions to patients afflicted with rare and devastating conditions. PANTHERx was recently recognized as the fastest growing healthcare company by Inc. magazine and in the top 5 places to work by Modern Healthcare. PANTHERx identifies opportunities every day to Reinvent Specialty, Revolutionize Pharmacy, and Redefine Care®, by developing focused solutions, bold innovation, and novel clinical services associated with the life-transforming therapies.

Company Benefits:

  • Medical Insurance
  • 401K (After 1 year of service)
  • Paid-Time Off


Insurance Resolution Specialist
Location: Pittsburgh, PA
Licensure Required: N/A
Job Type: Non-Exempt/Full-Time



The role of the Insurance Resolution Specialist is to process patient pharmacy claims accurately and quickly. Insurance Resolution Specialists will also liaise between patients, insurance companies, and government agencies to ensure patient receives medication accurately and timely and the appropriate entity is being billed. The Insurance Resolution Specialist will be required to work 10:30am until 7:00pm.  


  • Verify patient pharmacy coverage & processing info
  • Ability to process pharmacy claims on the patient’s behalf through a pharmacy benefit system
  • Obtain authorizations & overrides as needed
  • Apply patients for copay cards and/or assistance programs
  • Discussion with patient to review patient financial responsibility, obtain patient consent and payment
  • Ensure proper shipment set up
  • Work special projects
  • Attend staff meetings

Required Qualifications

  • High school diploma or general education degree (GED)
  • Minimum 2 years’ experience processing pharmacy claims
  • Strong written and verbal communication skills necessary to professionally and effectively convey ideas
  • Ability to multitask
  • Proficient with EDS billing systems, Excel and Word


Preferred Qualifications

  • Experience or knowledge within the healthcare industry, particularly a mail order or specialty pharmacy
  • Experience with CPR+