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