Payor-Partner Program Specialist- Remote
: Job Details :


Payor-Partner Program Specialist- Remote

KPH Healthcare Services

Location: Syracuse,NY, USA

Date: 2024-12-02T08:35:02Z

Job Description:

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.

  • 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

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.

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