Account Care Educator - Specialty Pharmacy

About the role

You will work directly with healthcare providers & insurance plans/payers to gather information about a patient's insurance and coverage for a specific pharmaceutical product. You will support healthcare providers with questions regarding coding and billing, and navigate complex reimbursement issues.

Responsibilities

• Support healthcare providers with questions regarding coding and billing, and navigate complex reimbursement issues
• Single point of contact for questions and inquiries from the prescriber, patient, and field agent by territory
• Identifies applicable programs and facilitates next steps
• Holistically communicates the statuses of all patient support activities
• Liaison with other program-specific Assist resources to secure outcomes for active patients
• Accepts inbound calls for assigned territory or overflow of other territories and provides one call resolution support
• Ensures protection is insured
• Performs other related duties as assigned by management

Requirements

• College degree is preferred or high school diploma or equivalent combination of education and experience
• Previous work experience in Medical Reimbursement or Customer Service
• Submitting billing data to appropriate insurance providers
• Processing claims and resolving denial instances
• Achieving maximum reimbursement for services provided
• Completing Medicare and Commercial insurance claim submission
• Documenting and reporting payment information
• Professional level skills in computer use, including but not limited to Microsoft Office, email, web-based applications, and keyboard skills
• Demonstrated strong written and verbal communication skills with providers, patients and insurance companies
• Interpersonal skills to facilitate work with a wide range of individuals and groups from culturally diverse publics
• Problem solving skills

Qualifications

• Attendance/Punctuality - Is consistently at work and on time; Ensures work responsibilities are covered when absent; Arrives at meetings and appointments on time
• Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments
• Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan
• Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments
• Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality
• Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives
• Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce
• Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values

Skills

• Treats people with respect
• Keeps commitments
• Inspires the trust of others
• Works with integrity and ethically
• Upholds organizational values

Benefits

• Supportive, progressive, fast-paced environment
• Competitive pay structure
• Matching 401(k) with immediate vesting
• Medical, dental, vision, life, & short-term disability insurance

Pay

Competitive pay structure

Schedule

Supportive, progressive, fast-paced environment