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Benefit Coverage Specialist

2 months ago

Chester, Virginia, United States EVERSANA Full time
Job Summary

Eversana is seeking a highly skilled and dedicated Program Specialist II to join our team. As a key member of our patient services support center, you will provide exceptional support to patients and healthcare providers, ensuring seamless benefit coverage and reimbursement processes.

Key Responsibilities
  • Deliver personalized support to patients and healthcare providers through phone and online interactions.
  • Investigate and resolve insurance benefit-related inquiries, including coverage and out-of-pocket costs.
  • Collaborate with patients and healthcare providers to resolve payment, reimbursement, and denial issues.
  • Assist with prior authorization and medical necessity processes, benefit verification, and prior authorization assistance.
  • Administer comprehensive searches for alternate reimbursement resources, such as state and federal assistance programs, and enrollment assistance for qualified patients.
  • Respond to customer inquiries, sales representatives, and business partners in a timely, courteous, and professional manner.
  • Enter orders, change orders, track shipments, and enter customer notes to complete customer/consumer transactions.
  • Process patient assistance applications according to business rules of the program.
Requirements
  • 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 and work independently as a team player.
  • Positive attitude, accurate, and detail-oriented.
  • Strong computer skills with a working knowledge of Microsoft Word, Excel, and PowerPoint.
Preferred Qualifications
  • Customer service and/or call center experience.
  • Patient assistance, reimbursement, and/or pharmacy benefit management experience.
  • Medical billing and coding experience.