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Spravato Care Coordinator

4 weeks ago

Morrisville, United States TEKsystems Full time

My client, a reputable healthcare company in Morrisville, NC, is hiring for a Spravato Care Coordinator with competitive pay and growth opportunity

Job Description:

  • Care Coordinator may be regionally aligned and will serve as an expert on all aspects of benefit coordination, and other forms of available support and will be responsible for handling healthcare provider and/or patient interactions.
  • May serve as an advocate to patients regarding eligibility requirements, program enrollment, affordability support, and general access for prescribed therapy.
  • Establishes relationships, develop trust, and maintain rapport with healthcare providers and/or patients.
  • Serves as direct point of contact to health care providers for ongoing support and relationship development by acquiring and delivering detailed information regarding a program and/or a patient.
  • Strong working knowledge and ability to understand and explain benefits offered by all payer types including private/commercial and government (i.e., Medicare, Medicaid, VA and DOD); with expertise in Medicare Part B
  • Navigates through payer challenges by asking appropriate questions to obtain the necessary result.
  • Acts as an assigned liaison to client contacts (e.g., regional contact for sales representatives)
  • Maintains records in accordance with applicable standards and regulations to the programs/promotions.
  • Follows program guidelines and escalates complex cases according to SOPs, Call Guides, and other program materials.
  • Liaison between Program Management, other internal stakeholders, and healthcare providers
  • Provides unparalleled customer service, with attention to detail, while serving as a brand advocate and program representative; understands the importance of achieving quality outcomes and commits to the appropriate use of resources.
  • As a program’s “eyes and ears”, works with all levels of Program Management on a day-to-day basis to maintain open lines of communication and share awareness regarding patient status, prescriber feedback/satisfaction, coordination challenges and program effectiveness.
  • Understands the nature of the disease states of patients of the program.
  • Assesses situations to act and intervene where needed to obtain a timely result.
  • Maintains a high level of ethical and professional conduct regarding confidentiality and privacy.
  • Helps maintain team morale by consistently demonstrating a positive attitude and strong work ethics.
  • Utilizes the necessary resources for conflict resolution as needed.
  • Identify and report pharmacovigilance information as required by client(s) (i.e., Adverse Events)
  • Other responsibilities as assigned by Program Management

Qualifications to Apply:

  • Associate or bachelor’s degree and 3 years of reimbursement/insurance, healthcare billing, physician office, health insurance processing preferred, or in lieu of a degree, a High School diploma or equivalent with 5 years of reimbursement/insurance, healthcare billing, physician office, health insurance processing.
  • Call Center/HUB or customer service experience with progressive levels of responsibility within a service driven environment required.
  • Excellent communication skills; orally and in writing
  • Strong working knowledge of prior authorization and appeals is required.
  • Strong knowledge of medical and pharmacy insurance terminology and reimbursement/insurance, healthcare billing, physician office, health insurance processing or related benefit coordination experience
  • Excellent problem-solving and decision-making skills required.
  • Attention to detail and committed follow through in communication with patients, providers, and internal/external stakeholders.
  • Strong organizational skills
  • Willing to work in a dynamic, fast paced environment and can multi-task.
  • Ability to, and help team, adapt to change while maintaining Program standards.

APPLY NOW

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.