Patient Service Representative

3 weeks ago

Hanover, United States SSi People Full time

Job Title: Patient Support Specialist


Client: Healthcare and hospital


Shift Hours: 9:30am-6pm


Job Description:

The Patient Support Specialist provides access to care for prescription medications, interacting with patients, physicians, and pharmacies as part of a high-touch service team. Responsibilities include managing the patient experience, offering program information, eligibility, reimbursement support, and ensuring ease of use for copay assistance programs. The role involves responding to calls, processing claims, resolving issues, and providing empathetic customer service in a high-volume contact center environment. Preferred experience includes healthcare, case management, and medical billing, with a focus on customer empathy and effective communication.


What You will Do:

  • Responds to inbound phone calls and claims (as well as outbound calls) to/from patients, physicians, and pharmacies, services their access to care and reimbursement needs and responds. Focus on patient empathy and the consumer experience with the goal to assure our patients on ease of use of program goals and ultimately driving access to care and medication adherence. Based on volume, may also process claims and/or may answer phones.
  • Refers requests for escalation as needed and engages other internal areas such as Program Management, IT and other Contact Center teams to resolve issues.
  • Performs other assignments as needed.
  • May be asked to assist other departments as needed with an administrative task (mail sort and/or claims processing)


Required skills:

  • Call Center operating metrics and performance management experience (a plus)
  • Knowledge of pharmacy benefits, health care insurance, and/or medical billing (a plus)
  • Will be trained to support programs, clients and/or job functions as appropriate.
  • Some experience with any Third-Party system (SelectRx, Pro-Care, FSV) (a plus)
  • Experience with Call Center software (Five9, In-Contact, or similar) (a plus)
  • Fluent in English/Spanish (a plus).
  • 1+ years in a health care or case management experience in a high-volume contact center environment or similar environment preferred.
  • Experience working in pharmacy benefits, health care insurance, and/or medical billing (preferred)
  • Communication skills: ability to convey information in easy-to-understand language. Actively listens; Uses writing effectively to create documents, Uses correct spelling, grammar, and punctuation.
  • Customer Focus; high level of empathy and emotional intelligence; Focuses on opportunity to service patients with a high level of empathy
  • Adaptability: Adapts to a variety of situations easily and effectively navigates situations
  • Problem Solve, Thinks critically, and problem-solves issues to resolution."


Skills:

  • Case management
  • Billing
  • Pto
  • Medical billing
  • Patient care


Additional skills:

  • Pharmacy benefits
  • Medical invoicing
  • Financial project management
  • Metrics
  • Claims
  • Outbound calls
  • Claims processing
  • Answer phones

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