Responsibilities:

•Investigate patient’s insurance coverage when applicable by conducting payer calls, utilizing insurance intel and web tools
•Review financial documents for completion to assist with assessing for program eligibility
•Provide subject matter expertise on medical and prescription insurance coverage, medication prior authorization process, and alternate financial assistance opportunities for patients
•Apply Client’s Patient Assistance Program standards to each case to render the appropriate decision of approval or denial into the program
•Conduct the outreach process to obtain missing information that is required to complete an application assessment
•Ensure all patient cases are documented in the Customer Relationship Management System (CRM) in accordance with all business rules and policies
•Receive and handle incoming calls from patient’s and HCPs
•Complete renewal and year end recertification’s process as determined by the Client’s Patient Assistance Program
•Readily assists on special project within job scope to improve reimbursement optimization when requested by management

Qualifications:

•High school diploma or equivalent required. College or a 2-year Associate Degree is preferred
•A minimum of 1-3 years’ experience within a call center; healthcare provider, PBM, Specialty Pharmacy or Retail/Mail Order Pharmacy setting, strong core insurance (Medical and Pharmacy Benefit) knowledge preferred
•Knowledge of online benefit verification systems or similar experience strongly required
•High quality customer service skills
•Strong attention to detail and with the ability to multi-task required; strong analytical skills preferred
•Ability to express ideas clearly in both written and oral communications