Full-Time Health Care Call Center Representative

The Program Specialist II will provide dedicated support to patients and doctors for activities related to benefit coverage, payments, reimbursements, denials, and general inquiry phone calls.

Essential Duties and Responsibilities:

• Provide dedicated, personalized support via phone and online portal.
• Complete investigations and answer questions regarding insurance benefits, including coverage and out-of-pocket costs.
• Collaborate with patients and doctors on issues related to payments, reimbursements, payment denials, and appeals.
• Make outbound calls to customers for additional information.
• Assist with prior authorization and medical necessity processes, benefit verification, and prior authorization assistance.
• Administer searches for alternate reimbursement resources (state/federal assistance programs) and enrollment assistance.
• Respond to customer, sales representative, and business partner inquiries; follow up on requests professionally and courteously.
• Maintain a positive and helpful attitude towards customers/clients.
• Enter orders, change orders, track shipments, and enter customer notes.
• Process patient assistance applications according to business rules.
• Perform other tasks as assigned.

Expectations of the Job:

• Assist with benefit verification and prior authorizations.
• Enter orders, change orders, and enter customer notes to complete transactions, maintaining logs and records.
• Act as primary contact for healthcare providers to obtain patient enrollment and insurance information.
• Adhere to company and client policies/procedures.
• Focus on results professionally, ethically, and responsibly.
• Demonstrate accountability in work practices and expectations.
• Foster collaboration and team-oriented attitude.
• Communicate effectively with clarity and transparency.
• Use critical thinking to evaluate and solve work/customer issues.
• Seek assistance in solving problems collaboratively.
• Maintain excellent attendance.

Minimum Knowledge, Skills, and Abilities:

• High School Diploma and 4 years’ experience or Associate’s Degree and 2 years’ experience in a healthcare setting.
• Excellent oral, written, and interpersonal communication skills.
• Ability to multitask.
• Positive attitude.
• Accurate and detail-oriented.
• Ability to work independently and as part of a team.
• Ability to work in a fast-paced, metric-driven environment, remaining patient-minded.
• Strong computer skills with Microsoft Word, Excel, and PowerPoint.

Preferred Qualifications:

• Customer service and/or call center experience.
• Patient assistance, reimbursement, or pharmacy benefit management experience.
• Medical billing and coding experience.

What is the last date for applying to the job?

Which countries are accepted for this remote job?