Patient Engagement Specialist
Valeris · Indiana, United States · 4 wk ago
OTHR$50k/yrFull-time
About the role
The 11:30 AM - 8 PM ET shift is required for this role.
Key Responsibilities
- Build and maintain trusted relationships with patients by demonstrating proactive communication, delivering timely and accurate services, and showing a strong commitment to patient well-being.
- Ensure all interactions and relationship management practices comply with relevant healthcare laws and regulations.
- Demonstrate prior experience working with pharmacy benefit products and patients, or in immunology practices, to better understand patient needs and concerns.
- Conduct program welcome calls to patients, engaging them effectively and explaining available services and resources for their support.
- Demonstrate motivational interviewing techniques to actively involve patients in goal setting and achieving their healthcare objectives.
- Perform post Benefits Investigation calls to patients, clearly explaining coverage options to enhance patient understanding.
- Effectively handle all client inquiries that cannot be resolved through standard reporting processes.
- Address patient inquiries in accordance with applicable business rules, providing accurate and helpful information.
- Articulate complex reimbursement and billing information in a clear and concise manner to ensure patients comprehend their coverage benefits and financial responsibilities.
- Handle inbound calls as per the program-approved Frequently Asked Questions (FAQs).
- Exhibit excellent customer service skills, even in a fast-paced environment, and de-escalate any challenging situations in a professional and appropriate manner.
- Triage patients to appropriate internal or external resources, depending on their needs and requirements.
- Ensure proper documentation and recording of patient enrollment into the program, following established business rules.
- Provide patients with comprehensive information and education about products, including the course of treatment, insurance coverage benefits, anticipated out-of-pocket costs, potential financial assistance resources, and ongoing treatment support.
- Proactively manage assigned cases and tasks to maintain service levels and deliver excellent customer service to patients.
- Empower and inspire patients to take charge of their therapy plan as prescribed by their healthcare provider.
- Leverage electronic tools to identify benefits and payer coverage, conducting manual benefit investigations when necessary.
- Identify and communicate patients' plan benefit coverage, including any prior authorization, appeal, tier exception, or formulary exclusion requirements.
- Utilize electronic resources to obtain benefit coverage outcomes, and if needed, conduct outbound calls to payers and healthcare providers for follow-up.
- Support adherence services through the coordination of nurse follow-up, as applicable to the program.
- Coordinate the shipment of products through patient assistance programs and/or bridge programs from the PharmaCord pharmacy.
- Proactively communicate the need for re-verification of prior authorization or re-enrollment for patient assistance programs.
- Report adverse events, product complaints, special situation reports, and medical inquiries in accordance with established SOPs and Business Rules.
- Document all activities within the Lynk system to maintain accurate and up-to-date records, adhering to business requirements.
Qualifications
- Bachelor's degree strongly preferred or equivalent experience required; completion of a high school diploma or GED is required.
- Customer service and healthcare industry experience strongly preferred.
- Ability to work an 8.5-hour shift between 8 am to 9 pm, Monday to Friday required.
- Bi-lingual in English and Spanish or Chinese/Mandarin is a plus.
- Commitment to the mission of care coordination.
- Passionate, trustworthy, and empathetic when working with patients.
- Good communication and interpersonal skills and ability to speak concisely to patients.
- Flexible and adaptable in response to changing patient and healthcare providers’ needs.
- Professional telephone etiquette.
- Self-awareness of your own emotions and the potential impact on others.
- Basic computer knowledge.
- Ability to multitask effectively.
- Recognition of emotions and their effects.
- Manage disruptive impulses.
- Maintain standards of honesty and integrity.
- Manage standards of honesty and integrity.
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- Manage standards of honesty and integrity.
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- Manage standards of honesty and integrity.
- Manage standards of honesty and integrity.
- Manage standards of honesty and integrity.
- Manage standards of honesty and integrity.
- Manage standards of honesty and integrity.
- Manage standards