Healthcare Customer Service

POSITION SUMMARY
The Program Specialist is responsible for supporting the operations of InTeleCenter- programs including, but not limited to, reimbursement hotlines, patient assistance programs, foundations, safety surveillance programs and compliance programs. The focus of the Program Specialist is to help patients or providers access the therapies they need. The Program Specialist responds to requests from customers, who may include, but not limited to, physicians and their staff, hospital staff, pharmacists, patients, family members or friends of patients, distributors, and members of the clients' sales forces. The Program Specialist also performs reimbursement support functions as project requirements.

ESSENTIAL FUNCTIONS
1.Respond to inbound calls from customers, triage calls as appropriate, document calls in appropriate database, and handle/escalate calls per program specifications.
2.Conduct outbound calls per program specifications.
3.Conduct insurance verifications to confirm patient benefits, facilitate the prior authorization process on behalf of customers, assist with problem claims, and perform case management to identify insurance and alternative funding sources per program specifications.
4.Screen and process patient assistance applications by determining eligibility and making outbound follow up calls as necessary. Update computer systems on patient enrollment, denials, approvals, payment processing, withdrawals, shipments, and caller requests per program specifications. Respond to inquiries regarding PAP operations and requests, such as status of patient enrollment status, product shipments, and returns. Also work with distributors and manufacturers to request and track product shipment.
5. Other duties as assigned.

Working hours: 6:00am-3:00pm 8:00am-5:00pm

QUALIFICATIONS
Knowledge:-The Program Specialist will hold a Bachelors degree or evidence of continual work toward a degree strongly preferred. Candidates without a degree should have a High school diploma and 4 or more years health care or customer service work experience.

Experience:-Health care reimbursement interest or experience strongly desired. Customer service experience required.

Skills/Aptitudes:-Strong customer service and communication skills; good initiative; ability to grasp concepts; organized and thorough in work; ability to multi-task and manage workload; good follow up and attention to detail; ability to address problems proactively; uses good judgement and knows when to involve others; computer literacy. Reliable and able to meet attendance and punctuality requirements of the position.
WORKING CONDITIONS
Normal office conditions. Program Specialists typically work an eight-hour workday, with an hour or half hour of unpaid hour for lunch. Occasional overtime may be required.