Payor-Partner Program Specialist- Remote
Overview
Scope of Responsibilities: Works under general supervision. Follows standard procedures to accomplish assigned tasks. Assist in orienting and training employees
Job Summary: Responsible for all aspects related to management of hub services relationships, entering of medication orders, and customer service for patients/providers in a call center environment.
Responsibilities
- Provide direct support and serve as primary point of contact patients of designated third-party payers
- Follow customized patient support service models and programs to meet and exceed client expectations
- Follow established protocol and non-standard service models to provide the highest quality of services to patients
- Serve as subject matter experts on the intricacies of selected payer partner programs and assist patients in ensuring the correct triage and handling
- Responsible for assisting in the implementation of process improvement to ensure a streamlined patient relationship consistent with selected payer specifications. This may include accessing systems such as partner CRMs to investigate patient needs more fully.
- Responsible to receive triage patient calls from general call center for handling.
- Responsible for accurate selecting billing and shipping methods for incoming patient orders and setting up delivery of patient orders as necessary
- Customer service coverage for incoming calls and directing incoming calls to appropriate staff as needed
- Document patient reported information into TherigySTM
- Document and reporting information via McKesson EnterpriseRX
- Document and research plan specific information in partner CRM/tools.
- Provides resolution to customer service issues to ensure member satisfaction
- Work with members to provide resolution to payment related issues on accounts/orders
- Maintain and keep reasonable production as determined by supervisor
- May assist in orienting and training new employees
- Responsible for completing all mandatory and regulatory training programs
- Perform other duties as assigned
- May assist in training new employees
Qualifications
Job Skill Requirements:
- Broad knowledge of medications, physician orders, and pharmacy systems
- Effective communication skills
- Outstanding customer service skills
- Excellent organization skills
- Ability to multitask and prioritize
- Excellent computer and keyboarding skills
Educational Requirements:
- Minimum: High School Diploma or GED
- Preferred: Pharmacy technician or related certification
Experience:
- Past experience in a customer service-related field
- Preferred: 12 months experience in a call center environment
- Preferred: 24 months experience as a pharmacy technician
Compensation
$18.50 - 22.00 per hour
The final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience, and education.
KPH Healthcare Services , Inc. is a multistate organization and abides by all local, state, and federal regulations as it pertains to minimum wage requirements.
Originally posted on Himalayas