Customer Care Specialist

1 month ago

Fargo, United States Thrifty White Pharmacy Full time
Job DescriptionJob DescriptionPRIMARY OBJECTIVE:
Provide excellent customer service as the main contact for stores through phone, intranet and email requests. Navigate and utilize Thrifty White technology to fully research and resolve issues as communicated by customers and store personnel, including but not limited to billing and rebilling claims to the responsible party, submitting Prior Authorization requests, preparing and organizing data, and supporting all company programs and initiatives.

MAJOR RESPONSIBILITIES:
  • Provide excellent service to customers and stores via telephone, email and in writing.
  • Address all aspects of the customer or store issue, including researching billing questions, billing and rebilling claims, completing Prior Authorization requests, and taking payment information over the phone. If immediate resolution is not possible or additional research is needed, provide timely follow up.
  • Prepare and organize data to support company programs and processes.
  • Review current customer billing options and facilitate payment of medications appropriately
  • Follow up on Prior Authorization requests, communicating results to appropriate parties as needed.
  • Verify patient information to ensure account accuracy and HIPAA compliance.
  • Verify demographics and document allergies.
  • Research and resolve private pay account balances, including billing / rebilling to facility accounts or third party insurance, creating payment plans
  • Use TWRx, insurance phone lines, Intranet, Internet, MN ITS, and other resources as needed to complete rebilling.
  • Bill customers as appropriate for copays and non-covered items to ensure payment is received and applied.
  • Document actions taken and scan correspondence as appropriate to customer accounts.
  • Partner with coordinators and leadership to assist in implementing improvements to these processes.
  • Maintain confidentiality of all patient PHI, following HIPAA guidelines and TWP policies.
  • Assist with special projects as needed and requested by coordinators and leadership.
  • Learn and implement new and changing technologies on an ongoing basis.
  • Maintain flexibility as work roles / job responsibilities change as environment requires.
  • Maintain a well groomed appearance in accordance with company guidelines to present a professional image of the office.
  • Perform maintenance duties that support out services to our patients
MINIMUM QUALIFICATIONS
Education, Experience, Skills and Abilities:
  • Graduation from a high school or GED equivalent; or any combination of education and experience which demonstrates the ability to perform the job. Working knowledge of business math required. Communications or public relations courses are helpful. Prefer one year experience in a similar position requiring sales and customer service skills.
  • Excellent verbal and written communication skills, including the ability to communicate with customers, A/R team members, internal and external partners, and leadership.
  • Excellent follow thru to ensure work is done correctly the first time and the customers concerns are addressed as quickly as possible.
  • Background and familiarity of insurance processing. If background does not exist, must be able and willing to quickly pickup new knowledge and apply it quickly.
  • Moderate computer skills, including Word, Excel, and Outlook.
  • Ability to:
    • Troubleshoot and problem solve using all tools and resources available prior to escalating the issue
    • Operate phones and copy/print/scan machines
    • Prioritize, multitask, and manage workload
    • Handle stressful situations and difficult customers in a polite and professional manner
    • Maintain effective working relationships with specialists and leadership
    • Maintain confidentiality
    • Must have the ability to have and maintain a clear record without exclusion, sanctions or debarments with the Office of the Inspector General at the time of hire and monthly thereafter.

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