Payor-Partner Program Specialist

Job Duties

• Provide direct support and serve as primary point of contact for 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
• Assist 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
• Receive triage patient calls from general call center for handling
• Absorb and set up billing and shipping methods for incoming 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 report 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
• Complete all mandatory and regulatory training programs
• Perform other duties as assigned
• May assist in training new employees