DescriptionThis role is for one of the Weekday's clients
We are looking for a skilled Contractor with hands-on experience in healthcare, insurance verification, and specialty pharmacy operations to support an advanced AI healthcare automation project. The role involves developing structured and high-quality benefits investigation call scripts that guide payer communication and improve the efficiency of verification workflows.
RequirementsKey Responsibilities:
-  Develop and refine phone call scripts to collect accurate eligibility and benefits details for specialty medications. 
-  Translate payer requirements and documentation into clear, natural-language questions that yield complete and auditable responses. 
-  Incorporate payer-specific nuances, including medical vs. pharmacy benefits, prior authorization rules, step therapy, and specialty distribution pathways. 
-  Continuously improve and optimize scripts based on quality assurance feedback and real-world payer interactions. 
-  Ensure all documentation is accurate, consistent, and compliant with industry standards. 
Qualifications:
-  Strong background in specialty pharmacy operations, payer communications, or benefits investigation. 
-  Deep understanding of insurance and reimbursement concepts for specialty medications, including coverage restrictions, NDC, J-codes, HCPCS, and ICD-10. 
-  Proven ability to write concise, conversational scripts that guide users in obtaining complete payer information. 
-  Excellent written communication, documentation, and attention to detail. 
-  Prior experience conducting payer calls or working in benefits verification is highly preferred. 
Engagement Details:
-  Commitment: ~20–30 hours per week 
-  Type: Independent Contractor 
-  Location: Remote