Program Specialist II
2 weeks ago
Eversana is a global leader in commercialization services for the life sciences industry. We are seeking a highly skilled Program Specialist II to join our team.
Job Summary:
The Program Specialist II will provide dedicated support to patients and healthcare providers for activities related to benefit coverage, payments, and reimbursements. This role will involve investigating and resolving issues related to insurance benefits, prior authorizations, and medical necessity processes.
Key Responsibilities:
- Provide personalized support to patients and healthcare providers through phone and online portal interactions.
- Investigate and resolve issues related to insurance benefits, including coverage and out-of-pocket costs.
- Collaborate with patients and healthcare providers to assist with issues related to payments, reimbursements, and payment denials.
- 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.
- Respond to inquiries from customers, sales representatives, and business partners in a timely and professional manner.
- Enter orders, change orders, and track shipments to complete customer transactions.
- Process patient assistance applications according to business rules.
Requirements:
- High school diploma and 4 years of experience or associate's degree and 2 years of experience in a healthcare setting.
- Excellent oral, written, and interpersonal communication skills.
- Ability to multitask and work in a fast-paced environment.
- Positive attitude and ability to work independently and as part of a team.
- Strong computer skills with a working knowledge of Microsoft Office.
Preferred Qualifications:
- Customer service and/or call center experience.
- Patient assistance, reimbursement, and/or pharmacy benefit management experience.
- Medical billing and coding experience.
About Eversana:
Eversana is a global company with a commitment to diversity, equity, and inclusion. We are an equal opportunity employer and welcome applications from candidates with diverse backgrounds and experiences.
How to Apply:
Please submit your application, including your resume and cover letter, to [insert contact information].
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