Location: Clarksville,IN, USA
Description:
When you join the team as the Patient Services Associate, you'll have the opportunity to make a difference in the lives of our patients each day as they look to you as part of their dedicated support team for helping them navigate the tricky process to getting access to their complex medication. You'll compassionately deliver an exceptional experience to many patients per day always remembering that every prescription or document belongs to a real person who is looking for thorough and efficient management of their records. You'll adjust your approach to their needs by communicating clearly, focusing on the accuracy of the details of their medical records and your mastery of the program requirements, and ensuring their prescriptions or cases are handled timely.
A typical day in this role will include ownership of your patients cases from initiation to closure to include; benefit investigations, prior authorizations / denial appeals, determining financial qualifications for assistance programs and assisting patients or other callers/stakeholders through resolution (via email, inbound/outbound calls and using our patented technology) by using your critical thinking skills and your knowledge of the program and industry rules and standards. This role requires a high level of ownership, attention to detail and patient focus and will put your problem-solving skills to the test!
RELATIONSHIP MANAGEMENT:
- Builds trusted relationships with patients, prescribers, client stakeholders through proactive communication, timely and accurate execution of deliverables and demonstrated relentless passion for helping patients
- Managing all relationships in a manner that adheres to all relevant laws, regulations, program-specific operating procedures and industry standards related to access and affordability, including HIPAA and insurance guidelines.
BENEFITS VERIFICATION:
- Performing patient level benefits verifications as applicable for all major medical pharmacy benefits plans.
- Completion of the template forms that provide patient level benefits Coverage Determination Summary.
- Coordination of prior authorizations based on payer guidelines and in compliance with law, regulation or guidance.
PATIENT ASSISTANCE:
- Review of patient assistance enrollment forms and any supporting documentation to asses patient eligibility for participation as per SOP's and program guidelines
- Determination of patients eligibility based upon program criteria for qualification
- Communicating the patients eligibility to the patient, healthcare provider, and/or pharmacy.
COMMNICATION:
- Performs program welcome calls to patients
- Performs post Benefits Investigation calls to patients and physicians explaining coverage options
- Manages all client inquiries unable to be determined by client through reporting
- Manages HCP inquiries
INBOUND CALL MANAGEMENT:
- Manages inbound calls as directed by the program-approved FAQ's (can be up to 50 calls per day during peak season)
- Triage patients to internal or external resources as appropriate
- Answer and assist inbound callers through resolution utilizing answers to frequently asked questions or by warm transferring callers to appropriate individuals
- Review and identify information that is missing and/or incorrect within program service requests/program applications
- Reporting of adverse events/product complaint inquiries received in accordance with SOP and good manufacturer practices.
Hours:
Monday-Friday 8am-5pm
Skills & Qualifications:
Customer Service
1+ year of Healthcare experience
Prior Authorization or Insurance Verification
Additional Qualifications:
- Service minded individuals - focus on recognizing and meeting the needs of others (especially patients and care partners)
- Trouble-shooting and problem solving individuals
- Tough conversations - able to be a patient advocate for patients with high prescription costs
- Ability to handle personal health information with confidentiality
- Commitment to honesty and integrity
- Professionalism and a strong sense of proper business and customer service etiquette
- Clear verbal and written communication skills
- Accountability for results
- Ability to plan and prioritize tasks with close attention to detail
- Positive Attitude
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.