Remote - Payor-Partner Programs Specialist

Scope of Responsibilities

• Works under general supervision.
• Follows standard procedures to accomplish assigned tasks.
• Assist in orienting and training employees.
• 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.
• Access systems such as partner CRMs to investigate patient needs more fully.
• Receive triage patient calls from general call center for handling.
• Accurately select billing and shipping methods for incoming patient orders and set up delivery of patient orders as necessary.
• Customer service coverage for incoming calls and direct 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.
• Provide 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.

Qualifications

• 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.
• Minimum: High School Diploma or GED.
• PREFERRED: Pharmacy technician or related certification.
• PREFERRED: 6 months experience in a call center environment.
• PREFERRED: 12 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.